Back Pain and Cancer

Back pain is generally a sign of a muscle or joint problem. It usually isn’t serious, and most people recover from back pain within a few days to a few months. Occasionally, back pain is a sign of something more serious, such as cancer. Back pain caused by cancer usually doesn’t resolve within a few days, gradually gets worse, doesn’t improve when lying down, and is often worse at night.

People developing this type of pain, especially when it is associated with unexpected weight loss, tiredness, weakness of the legs and arms, or changes in usual bladder or bowel habits, should see a doctor.

Spinal Tumours

Spinal tumours can cause pain by damaging the bone or pressing on the spinal cord or other nerves. Tumours that start in the spine are rare and tend to happen in younger people. Spinal tumours usually grow slowly. The most common type is osteogenic sarcoma (osteosarcoma), which is a cancer of the bone.

Spinal tumours can also grow inside the spinal cord. These include meningiomas, which are usually benign (non-cancerous) but can be malignant (cancerous).

Metastases to Bone

Metastasis occurs when cancer spreads from its original site to another part of the body. Certain types of cancer metastasise to bone, including breast, lung, kidney and prostate cancer. If this involves the spine, which is one of the most common places for metastasis, it can cause back pain with leg weakness.

Prostate Cancer

The prostate is a gland below the bladder than produces fluids involved in the creation of sperm. One of the signs of prostate cancer is hip and lower back pain.

Ovarian Cancer

Ovarian cancer has few symptoms, but one to look out for is lower back pain.

Rectal Cancer

Patients with late stage rectal (lower bowel) cancer can develop back pain because the tumour presses on the nerves.

Pancreatic Cancer

Patients with unresectable pancreatic cancer (cancer that cannot be removed surgically) may develop severe back and abdominal (tummy) pain.

Kidney Cancer

Kidney cancer (renal cell cancer) can show up as a dull lower back pain, just below the level of the ribs.

Lung Cancer

A dull backache unrelated to coughing can be a sign of lung cancer, as can chest or shoulder pain. Patients with lung cancer can also develop back pain from persistent coughing.

Multiple Myeloma

Multiple myeloma is a cancer of the white blood cells. In multiple myeloma, the bone marrow produces too many plasma cells, which then form tumours in the bone marrow and the outer parts of the bone. Multiple myeloma weakens the bones, increasing the risk of fracture, and can cause pain in the bones, including the back and ribs.

Other Metastases

If the cancer metastasises to the adrenal glands, this can cause dull back pain.

Managing Back Pain in Cancer

Pain caused by tumours pressing on the spinal cord or other nerves in the back can be treated by removing or reducing the size of the tumour (debulking) through surgery, or shrinking it through chemotherapy or radiotherapy. If the pain is caused by bone damage or instability, this can be treated with surgery.

Doctors can alleviate the pain associated with cancer by prescribing painkillers, including morphine. The painkillers may be delivered as tablets, or using a drip, a pump or a patch.