Can Back Pain Be a Symptom of Lung Cancer?

It is not uncommon for people to experience back pain with lung cancer. The pain can be related to a tumor that has spread to the spine or is pressing on a nerve. However, back pain has many causes and lung cancer is not the most likely one for most people.

This article will explore whether back pain could be a symptom of lung cancer, what the causes are, and treatment options.

back pain symptoms that may suggest lung cancer

Verywell / Hugo Lin

What Is Back Pain?

Symptoms of back pain linked to lung cancer may overlap with those of back pain that is caused by other conditions, such as a ruptured disc, arthritis, and osteoporosis. If the cancer has metastasized to the spine, symptoms can mimic those of an upper back injury.

Lung cancer-related back pain may feel dull like a muscle ache, or it may seem sharp like a pinched nerve. However, back pain caused by lung cancer also has distinct differences.

Red flags that suggest back pain may be due to lung cancer include:

  • Back pain that is present at rest
  • Back pain that is worse at night
  • Back pain that happens without any activity
  • Back pain that worsens the longer you lie in bed
  • Back pain that gets worse when you take a deep breath
  • Back pain that doesn't respond to physical therapy or other treatment

The back pain may come with other telltale lung cancer signs like a cough that won't go away or shortness of breath. Unintentional weight loss, chronic fatigue, or coughing up blood may further suggest lung cancer.

A condition called malignant spinal cord compression may develop in some people who have lung cancer that spreads to the spine. These symptoms include worsening back pain, weakness in the legs, and sometimes loss of urinary or bowel control. This is a medical emergency, and immediate treatment is needed to prevent complications such as paralysis.

Is Back Pain a Symptom of Lung Cancer?

Back pain can sometimes be a symptom of lung cancer. In fact, it may be one of the first symptoms of the disease. Bone pain in general is an initial symptom of lung cancer 6% to 25% of the time, with the spine being the most common site.

Causes of back pain in lung cancer include:

  • A tumor that is placing direct pressure on the structures of the back, most often in the mid to upper back rather than lower back
  • A tumor that is irritating the nerves that serve the lining of the lungs and chest wall, which may trigger a sharp and sometimes chronic nerve pain
  • A tumor that has spread to the adrenal glands

Back pain related to a spinal fracture may also make your healthcare provider consider lung cancer. With metastatic lung cancer, the cancer spreads to bones in around 40% of people. The most common sites of spread are the spine and the large bones of the legs.

Cancer that invades the vertebrae of the spine may result in brittle, weak bones, and compression fractures. These breaks that occur in a bone weakened by cancer are referred to as pathologic fractures.

Treatments and Management of Back Pain

There are many effective ways to treat back pain in people with lung cancer. The choice of treatment depends largely on the underlying cause. If the pain is caused by pressure from a tumor, treatments may include:

If cancer has spread to the bone, combining radiation therapy with drugs called bisphosphonates, often used to treat osteoporosis, may help. The drug denosumab usually provides significant pain relief and reduces the risk of fractures in affected bone as well.

When to See a Healthcare Provider

It can be easy to assume back pain will go away, especially if you've had it in the past and treated it successfully with pain relievers, ice packs, and rest.

However, if your back pain is not responding to treatment, gets worse over time, and/or goes on longer than six weeks, you should talk to your healthcare provider.

Summary

Back pain is common and usually a result of an injury or a slipped disc. However, in some cases, it can be a sign of lung cancer, and sometimes it is the first symptom of the disease. In lung cancer, the pain is usually caused by a tumor pressing on spinal nerves and vertebrae. Often, the pain is different from back pain that results from more common causes.

A Word From Verywell

If you have back pain that is getting worse or not going away, see a healthcare provider. Be sure to share any other symptoms you may have. If it is cancer, early diagnosis allows for early treatment, increasing your likelihood of a better outcome.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Lynne Eldridge, MD
 Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."