Pain Persisting After Bone Marrow Aspiration and Biopsy: Clinical Features, Pain Phenotypes, and Prospective Outcomes.

Purpose: This study aimed to evaluate the severity and pain phenotypes of chronic pain following bone marrow aspiration (BMA) and/or bone marrow biopsy (BMB). Patients and Methods: In this prospective observational study, 228 adult patients who had undergone BMA and/or BMB were screened at least three months after the procedure. Pain characteristics were assessed using the McGill-Melzack Pain Questionnaire, Visual Analog Scale, pain DETECT questionnaire (PD-Q), and Douleur Neuropathique 4 (DN4). Patients reporting pain underwent standardized physical examination focusing on sacroiliac joint provocation tests and pressure pain threshold (PPT) measurement using digital algometry. Results: Chronic pain persisting for ≥3 months was identified in 13 patients (5.7%). Although nociceptive pain features were most common, neuropathic pain components were identified in a substantial subset of patients based on PD-Q and DN4 scores. Physical examination suggested sacroiliac joint-related pain in some patients. PPT values were reduced at the biopsy site in patients with chronic pain, indicating increased local pain sensitivity. Conclusion: In this prospective observational study, chronic pain following BMA and BMB is an underrecognized but clinically relevant complication with heterogeneous pain characteristics. Although neuropathic pain features and findings suggestive of local sensitization were identified in a subset of patients, these observations should be interpreted cautiously given the limited number of affected individuals and the exploratory nature of the analysis. These findings nevertheless support the need for systematic post-procedural pain assessment after BMB.