The Link Between Lung Cancer and Back Pain

If you've been diagnosed with lung cancer, it's important to pay attention to back pain. Although that twinge you feel might be from lifting something heavy, it could also be a symptom of your disease.

About 1 in every 4 people with lung cancer say they've had back pain at some point since their diagnosis. Some first learned they had lung cancer after they went to a doctor to find out why their back aches.

Sometimes you're hurting because the tumor inside the lung is pressing on nerves in the back or the spine. The pain can also be a sign that your cancer has spread to your spine.

Diagnosing Your Back Pain

Tell your doctor right away if your back starts to hurt. He'll try to figure out the cause of your back pain to decide on the best treatments.

You may need to have tests that can help your doctor see the bones inside your back. These can include:

  • X-ray
  • CT scan
  • MRI scan
  • PET scan
  • Myelogram (X-ray or CT scan that's done after a doctor puts a dye into your spine)

Your doctor may also want you to get a blood test to check your calcium levels. If they are higher than normal, it could be a cause of your pain.

Causes of Back Pain Related to Lung Cancer

Your doctor will go over the results of the tests with you. He'll let you know if problems like these are causing your back pain:

Spinal cord compression. If lung cancer grows and spreads, it can put pressure on the bones that make up the spine and the spinal cord. This can lead to pain in your neck or upper, middle, or lower back. The pain may also spread to your arms, buttocks, or legs. Your back or neck may feel numb, weak, or stiff. If you start having symptoms of arm or leg weakness, get medical care right away.

Leptomeningeal metastasis. The inner layer of cells and tissue that covers the brain and spinal cord is called the leptomeninges. If your cancer cells spread to this area or get into the spinal fluid, it can cause back pain and other problems, such as headaches and weakness in your arms and legs.

High calcium levels. Lung cancer that spreads to the bones can cause calcium levels in your blood to go up, a condition called hypercalcemia. This can cause back pain as well as symptoms like nausea, vomiting, thirst, weakness, and headaches.

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Treatment

The treatments your doctor suggests for your back pain depend on the type of pain you have, how much it hurts, and the cause.

Pain alone. If your back pain just started or has slowly become worse, your doctor may recommend an over-the-counter drug, such as:

If the pain is severe, your doctor may give you a prescription for an opioid, such as:

Bone damage. If your lung cancer spreads to the bones in your spine and causes damage there, your doctor may suggest that you take special drugs that treat bone pain and help make your bones stronger at the same time. These medicines include:

Tumor-related pain. To treat your back pain, your doctor may need to treat the cancer that has spread from your lungs to your spine. This treatment could include:

High calcium levels. If you have high calcium levels, your doctor may suggest that you:

  • Drink more water
  • Have fluids put into a vein
  • Take drugs that lower your calcium levels

Palliative Care

You may want to ask your doctor to recommend a specialist in palliative care. They can help you manage your cancer-related side effects.

A palliative care specialist may suggest you consider some of these options in addition to or instead of pain medication:

When to Call the Doctor

If you begin to have a very sharp pain in your back, or your back pain suddenly gets worse, it may mean your cancer is pushing on nerves or bones in your spinal cord. If this happens, call your doctor right away or go to the emergency room.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on September 26, 2019

Sources

SOURCES:

National Institute of Neurological Disorders and Stroke: "Low Back Pain Fact Sheet."

American Cancer Society: "Signs and Symptoms of Lung Cancer."

Journal of the Advanced Practitioner in Oncology: "Back Pain in a Patient with Lung Cancer."

Dana-Farber Cancer Institute Insight: "Back Pain and Cancer: How Are They Related?"

Mayo Clinic: "Bone Metastasis."

CancerCare: "Caring for Your Bones When You Have Cancer."

Journal of Bone Oncology: "Incidence and consequences of bone metastases in lung cancer patients."

Oncology Reviews: "Bone Metastases: An Overview."

National Comprehensive Cancer Network: "When to Go to the Emergency Room."

Johns Hopkins Medicine: "Spinal Cord Compression."

Journal of Oncology Practice: "Cancer-Related Hypercalcemia.

JAMA Oncology: "Leptomeningeal Metastases."

Therapeutic Advances in Medical Oncology: "Bone and Brain Metastasis in Lung Cancer."

Memorial Sloan Kettering Cancer Center: "Leptomeningeal Metastases."

Insights Imaging: "Imaging of Urgencies and Emergencies in the Lung Cancer Patient."

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