The dreaded bone marrow biopsy.

I have a list in my head of medical procedures that I have seen on TV that I never want to have happen to me:

– fully conscious brain surgery
– any of those procedures you see on House where a needle is inserted into someone’s eye
– having a needle punctured into my chest to relieve pressure around the heart

On the second tier of those fears is a bone marrow biopsy. I blame years of watching medical TV shows where a bone marrow biopsy is shown as one of the most painful processes possible.

I had mine on Tuesday. I won’t say it was at all pleasant, but anyone can handle anything for 5 minutes. It wasn’t the worst thing I experienced- running half a mile on a broken/sprained ankle was worse. However, the pain in the minute of actual painful things during the procedure was intense.

If anyone is reading this is currently undergoing staging for cancer or has any other reason to have a bone marrow biopsy, there are alternatives to make the process smoother. Many people get IV drips of sedatives. I only took a percocet and an ativan as prescribed by my doctor before I went. And again, you can deal with anything for 5 minutes. Afterward, you’re pretty much a rock star.

The procedure for a bone marrow biopsy, which, in most cases, also includes a bone marrow aspiration, is fairly straightforward.

First, the doctor lays you on your side and covers you with a paper sheet so only the part of your hip/back that he is going to be working on is showing. You are cleaned and given an initial shot of lidocaine. This stings for a few seconds until it kicks in. Then you get a second, deeper shot of lidocaine that you cannot feel. In short, you will not feel anything until the needle pierces the bone because, unfortunately, bone cannot but numbed.

The doctor makes a small incision into your skin to make it easier for the needle to go in. First is the bone marrow aspiration where the liquid part of the bone marrow is sucked up. That hurts. It feels like a painful tugging from deep in your body, but after 30 seconds, it’s over. Next comes the bone marrow biopsy where a larger needle is inserted and removes a portion of the bone marrow itself. There was a lot of pressure and some more pain with this, plus the weird feeling of my doctor really leaning into me.

Then it was done. I was given a bandage, told to lay flat on my back for 10 minutes, and sent on my way.

My friend and I went for Mexican food afterward, if that’s any indication of anything.

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36 comments on “The dreaded bone marrow biopsy.
  1. Sue says:

    Allie,
    I’m so proud of how brave you are! There isn’t much you can do but what the doctors say, but attitude is everything, and you are taking this head on in a way that mandates success. I can’t wait to celebrate remission with you! *hugs* Sue

  2. […] most common are questions surrounding the bone marrow biopsy, which also happens to be one of my most read blog posts ever. One little procedure that causes so much […]

  3. RobinM says:

    Kudos to you; glad it went well for you. I had my fourth one in six years last Friday. Since the doctor has taken all of them from the same hip, this was the worst one yet. The doctor thinks scar tissue may have been the cause, but after two shots to numb the area I still felt everything… even the chipping of the bone. I am not recovering as quickly this time, either. It is not the end of the world to have one done, but I sympathize with anyone one has to have one. Don’t feel bad if you have a hard time of it. It is a trauma on your body… this is not a normal thing to have a body go through. Hang in there and I hope anyone having to have this done bounces back quickly.

  4. Kathy Bakke says:

    Thank you for this information. I am scheduled to have one next week and I am really nervous. Kathy

  5. Arcadi says:

    I just had my bone marrow test 2.5 days ago. It was in the pelvis area.
    The doctor also managed to hit the nerve – I saw the angels, and couldn’t walk for about 30 minutes.
    The first day the pain was horrible, I have no fever, no redness and no discharge. The pain today is about 25% less but it’s still there.
    If I touch the area I feel like internal hard piece of a%s, I’m using ice and Advil but not much help. Any words of wisdom?

    • aemorse says:

      Ouch! That sucks! Have you talked to your onc about Rx painkillers? I believe I might have been given a script even before my bone marrow biopsy, but luckily did not need to use them. If you are still in pain, call the oncologist! My experience with oncologists is that they are very welling to offer stronger stuff if it will help ease your suffering or calm your nerves. I’m so sorry that you’re going through this!

  6. alexlondon says:

    Yeah, it hurts. And once you’ve had one you can’t help dread the second. Mine (I’ve had 2) were made more unpleasant each time because the first sample wasn’t any good and so they had to do the final painful bit twice on each occasion.

    Mine tend to give me a couple of days of bone pain after – but then again, I get plenty of that anyway.

    If you are due your first – be stoic – you’ll live, and you’ll feel pretty proud of yourself afterwards. I know I’ll have to have another one in two or three months, and it won’t be the last.

  7. Jason says:

    I just had my second bone marrow biopsy (bmb) – my first was two years ago. My first bmb hurt like heck, but the next day I was fine.

    I had my second one a week ago. As with the first bmb I had a local, I was not put to sleep. This one hurt much more and has left me with a severe pain if ever I move in a certain way. It is hard to describe the various movements, but when I make them (hard to avoid) it is like being stabbed in the location of the bmb – hurts like heck!! Right now they are saying the problem will go away (but they don’t know why it is happening). It can’t go away fast enough…

    I don’t want to make anyone nervous about their biopsy; you just have to hope they do it in the right spot and don’t hit anything sensitive.

    • aemorse says:

      I think one of the most important things with BMBs is to make sure that the person doing it is very experienced. My onc has been doing them for 40 years – and tried to soothe my fears by telling me that he and his fellow med students used to practice on each other! Very Grey’s Anatomy at Harvard Med in the 60s. 😉

      I don’t know as much with leukemia, but with lymphomas, it can hurt more if you have disease in that part of the hip. Maybe that is part of why yours hurts? I hope they figure it out soon!

      • Sarah says:

        This is my first bmb. My onc mentioned Myoblastia Anemia. They diagnosed me with Systemic Lupus a year and a half ago – now I am not sure if I really had Lupus. My Dad died at 67 – they said he had Lupus. That was 31 years ago. They probably never heard of MA or MDS. My bones do hurt and the bmb frightens me terribly. How did you know you had lymphoma? Was that the diagnosis of your bmb? I have anemia, but my iron (ferritin) is high off the charts. My platelets, which were always too low are now accelerating. My RBC and WBC are below normal, and hemotocrit has dropped to 25. I am so sick that I feel I have cancer everywhere. Am I nuts?

  8. Aimee says:

    I’m due to have bone marrow biopsy Oct.31st. I’ve read where you can have IV drips of sedative to ease the pain. Is that true? I’m apprehensive and a bit scared. I have multiple myeloma. There is no cure. The best I can hope for is remission.

    • aemorse says:

      Hi Aimee,

      You can! However, some oncologists do not like to give it due to complications and most insurance companies will not cover it. In my opinion, it’s really not worth the extra thousand plus dollars to pay for sedation for a 5 minute procedure. It is something you can talk to your oncologist about. Do you have any oral anti-anxiety medications?

  9. Sarah Leftow says:

    Question: Why would your doctors not agree to sedation for such a painful procedure? Mine has been trying to talk me out of it, but there is no way I would do it awake. They sedate dogs! Why put a human being thru so much agony? There is pain afterwards – why have it during?

    • aemorse says:

      It’s not so much my doctors but my insurance. Insurance would not cover the sedation – and since I was just 4 months into my first job and barely getting by paying for cancer treatment as it was, my doctors were very self-aware of cutting costs that would be passed down to me. The procedure only takes about 5 minutes of pain, so many insurance companies decide that’s a negligible amount to deal with.

      • Ileana c.k says:

        Hi! I’m a 27yr old female that just had a BMB and aspiration done 4days ago–for anemia and low white blood cell count. I’m still sore and tender. I took no pain meds prior and received no sedation, only had local anesthesia–lidocaine and then OTC Tylenol around-the-clock after. I must say it was a painful procedure, but I did go in expecting it to be worse than what I’ve felt (that made it not too bad). My hubby was there for support and I made sure not to look at what they were doing. I also did deep breathing techniques which helped a lot (ie: in thru nose-out thru mouth). I must say, pressure and sharp instances of pain is what I remember most but it’s fairly quick. Mine took about 30min i believe, because I had to get numbed 2x and being young, the bone sample was hard to retrieve because its so dense. After it was over I felt a little off balance, as if I got off a ride, but they said it was normal. It only lasted about 10minutes or less. Within 30minutes I felt the deep sharp pain at the site. I took Tylenol and that helped take the edge off but it was sore. It takes time to heal, and I’m not quite there yet but almost. I get results Friday. I’m so thankful that its all over for now and I’m looking forward to finally getting to the bottom of my health issues 🙂

  10. Cathy says:

    does it leave a scar?

  11. hjkhv says:

    Cathy :
    Your comment is awaiting moderation.
    does it leave a scar?

  12. deian j says:

    I just had a double bone marrow biopsy(sample from the left and the right side). I must say it was quite possibly the most painful thing I have ever had done. You are right though, it is a short experience. Thr feeling after if not that bad either. Just feels like a bruise. Thank you for the information, I gave this a read prior to the procedure and it helped me better prepare myself.

  13. Henry says:

    I think the experience is different for each person. I had a really bad one yesterday. Went to the hospital with a little anxiety and the painful but quick bone marrow biopsy of 14 years ago somewhere in the back of my mind. Yesterday it was much more painful and took a very long time, more than one hour! After several attempts the hematologist couldn’t extract enough bone marrow nor bone itself. Then a pause was held to make me recuperate, as I had turned very pale from nausea. Blood pressure was taken, though I’m generally fit. Then the doctor continued but still couldn’t get enough tissue and she called in another specialist. He drilled at another spot in the pelvic bone, which hurt but quickly delivered the required amount of marrow and bone. I apologized to the dedicated medical team present for my body not cooperating and they apologized for the lenght and pain of the procudere. I should have an arrow tattooed at the second and good spot for the next time. Lab results out in 2 weeks, feel like Jean Claude van Damme has kicked me in the back.

    • aemorse says:

      That’s horrible! Do you know how often your hematologist does these procedures? Mine did them very regularly, including on young adults who tend to have dense bones. Additionally, he mentioned that in med school, he and his colleagues used to practice on each other so he also knows how it feels. I do think that his expertise really helped.

      Fingers crossed for good results!

      • Henry says:

        I had the impression that the hematologist had done it many times. The week before and on the day itself prior to the biopsy she said that her patients normally didn’t have much pain or discomfort. The second hematologist who took over and succeeded seemed to have more experience. I’ll ask for him if they ever have to do it again.If the marrow and bone are clear there won’t be a need to repeat it, unless the underlying follicular lymphoma becomes aggressive in future. Thanks very much for your sympathy.

      • Henry says:

        Great news! The result of the bone marrow biopsy shows that the Lymphoma has not spread to the marrow. Blood results were also good. The follicular NHL is localized in the parotid gland and probably the wait and watch method will be applied. No operation (yet) Let’s see how we’ll deal with this. Maybe the sword of Damocles will never fall……

  14. Jessica says:

    I may have to have this done in a few months. For me it is good to read the truth about something like this. I had a liver biopsy while awake in 2004 and I was told I would feel pressure. What a joke and the Dr. was a witch about it also. I don’t recommend an awake liver biopsy or having tubal litigation with a c-section. Those are two things I wasn’t properly warned about.

    The Nurse Practitioner at the Hematologist explained the bone marrow test to me when I was there in November. I started going to a Hematologist in 2011. I hadn’t had a regular dr in a while, but started going again because of my wrist/elbow pain and my fatigue. Ever since we had our youngest child, I haven’t been about to bounce back energy wise. Since then I have had all kind of tests & ruled out a lot of things. My Rheumatologist says I have Fibromyalgia. My ob/gyn says I need a hysterectomy. I had a minor surgery that revealed adhesions from my 2 c-sections. The hematologist says my platelets are too high and my white blood count is a little high. The platelets have been too high since March 2011. He has done ultrasounds and cat scans to check the spleen. I also ended up with a hemangioma on my liver. In the meantime, I ended up with more tests because my armpit nodes were swollen in one of the tests and I had a density in one of my breasts. The gastro dr says I have h. Pylori which is apparently not uncommon. Hopefully I will be able to have my hysterectomy soon and it will help some of my issues. I sound about 100, but I’m 35. Our youngest child is Autistic/non-verbal also, so that really doesn’t help either.

    Any advice on the test? Should I ask if I can take something to relax, but still function? Should I have someone go with me, if I have it done?

    P.S. I know this is a lot of info, but I’m tired of feeling like poo. As I write this, I realize I am apparently falling apart. 😛

    • Henry says:

      Dear Jessica,
      Regarding your questions: you should definitely bring someone along when you go for the bone marrow biopsy. You need to hold someone’s hand during the procedure. Talk to him/her in advance about how to distract and comfort you during the procedure. At some point it may help to have something cold on your forehead. Do ask for something to relax and get drowsy. I didn’t have it and regretted that. Also don’t drive back home yourself, which I did. It’s quite uncomfortable. Get some painkillers in advance, to use when the local anesthesia wears out. Good luck and try not to think about it too much. It’s just a necessary hurdle to getting better.

  15. Jessica Gonzalez says:

    I had my biopsie in November.
    I am a nurse, and therefore am pretty familiar with invasive procedures. However, I had never assisted with this particular procedure. I had this procedure done, without any type of sedative on board. And I am telling you I wished like hell I had. I have broken several bones, and have had a few major surgeries. With that being said, I think I am a pretty good judge of what hurts and what does not. And I am telling you this procedure hurts. Do Not let any body perform this procedure on you, unless they give you a sedative before hand. Yes it only lasts about 5 minutes but, it’s like 5 minutes under water. I don’t mean to frighten anyone. I just don’t want anyone experiencing what I did if it can be helped. I truly believe if I had known to take something before hand, the procedure would have been far less traumatic.

  16. David land says:

    I just had my 9th bone marrow biopsy yesterday. My first one in may of 2012 was done awake and it was very painful he had to in twice because the first sample wasn’t good enough. Now the last 8 I have had done at moffitt cancer center in tampa Florida. As long as you have someone to drive you home they will give you deep sedation with propofol. You don’t feel or remember a thing. You are brought into the procedure room asked to lay on your side they hook you up to monitors and a little bit of oxygen and say have a nice nap and next thing you remember you are in recovery. It’s great will never do a BMB anywhere else. I am sore after this one doc might have hit a nerve but its better to deal with the next day then when it actually happens. Plus I am prescribed dilaudid so it really helps to have a script for pain meds.

  17. jacqueline says:

    I have to have one done tomorrow? And I’m scared crapless! I’ve been through hell and over but this is the cream of the crop!

    • aemorse says:

      Try not to stress out too much! When it’s over, you can impress people with how fierce you are! Did your doctor give you something for anxiety? It helps, a lot. Thinking good thoughts for you!

  18. aemorse says:

    Call in the morning. What time is your appointment? If you’re really nervous, they can call in a script for an anti-anxiety drug to take beforehand. I think it hurt less for me that other people in part because I had taken a horse’s dose of Xanax before the fact.

    jacqueline :

    No he didn’t maybe he has the meds in his office!?

  19. Cory says:

    I had BM biopsy a week ago today and I’m going in later this afternoon to get my results. Had NHL (t cell rich large b cell) in 2008 and my lymph nodes have been bigger after every CT scan since. So, they’ve feared my cancer is coming back…they’ve surgically removed lymph nodes from my neck, both armpits, and groin, where they all have come back: inconclusive. My blood work has consistently been off for a few years and my onco said lets do a BM biopsy and get a good idea about what is going on. We did the BM biopsy and after my onco said I have the hardest bone she’s ever experienced. My wife watched the procedure and she couldn’t believe what my Onco was doing to get the piece of marrow. It took every ounce of strength my onco had to tap into the bone and retrieve the piece they needed. I felt everything…. the pressure, the weight of my onco on top of me bearing down, all of it, and Im a big, muscular dude, 5’11” 240 lbs., a little overwheight but not fat. All that being said, I’m still in pain a week later….pain to touch, pain when I sit or sleep, pain that goes down my hip. She told me I’d be sore for a few days, especially being my bone was so hard, but I’m concerned that we’re a week out and it’s still really sore.

  20. Jessica E says:

    Thanks! My blood counts were good and I did not have to have the aspiration. Hopefully they will stay good and I won’t need one. 🙂

  21. I just had my first Bone marrow biopsy and aspiration. I booked me an OR time and got me the happy juice to sleep land. I knew that this was an procedure, that I would not want to be awake for. AND:::::: It was awful waking up to that pain. It was so intense and it was not “nothing” some people go on about. I am sorry, but I have had 7 major surgeries. Staples, stitches missing organs kind of operations, and this was TOP 3 worst pain after. It’s day 3 of recovery, and I still hurt like a high school football team used my ass as a training object. GET a general and go to sleep, ask for plenty of drugs and do not take no for an answer. I have no idea what I have. They found bence jones markers in my urine and blood. Hope my experience can help someone.

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