Is Upper Back Pain a Sign of Lung Cancer?

Back pain can be a symptom of lung cancer. However, upper back pain has many causes and lung cancer is not the most likely one. Kidney stones and arthritis are much more common causes of back pain.

Other forms of cancer, like kidney, pancreatic, or uterine cancers can also cause back pain.

Back pain from lung cancer is often caused by a tumor that has spread to the spine or is pressing on a nerve. The pain can feel dull or sharp. It may be worse at night and when you take a deep breath.

This article will go over how to know if back pain is from lung cancer or another more common cause.

How Could Back Pain From Lung Cancer Feel?

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. 

The symptoms of back pain from lung cancer can overlap with those of back pain caused by other conditions, such as a ruptured disc, arthritis, and osteoporosis. If cancer has spread (metastasized) to the spine, the symptoms can be similar to those from 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 back pain could be from lung cancer include:

• Back pain that is present at rest
• Back pain that is worse at night
• Back pain that happens without 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 signs of lung cancer, like a cough that will not go away or shortness of breath. Unintentional weight loss, chronic fatigue, or coughing up blood are also other signs and symptoms of lung cancer to watch for.

Back Pain and Lung Cancer: What’s the Link?

Back pain can be one of the first symptoms of lung cancer. Bone pain is an early symptom of lung cancer in 6% to 25% of people, and the spine is the most common place for pain.

Causes of back pain in lung cancer include:

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

Back pain related to a spinal fracture could make your healthcare provider want to test you for lung cancer. In metastatic lung cancer, about 40% of people have cancer that spreads to bones. The most common sites of spread are the spine and the large bones of the legs.

Cancer that gets into the vertebrae of the spine can lead to brittle, weak bones, and compression fractures. Breaks that occur in a bone weakened by cancer are called pathologic fractures.

Upper Back Pain: When to Worry 

If you've had back pain in the past and treated it with pain relievers, ice packs, and rest, you might just try to “wait it out.”

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

Even if you don’t have lung cancer or another kind of cancer, there are other serious causes of chronic back pain. 

Once a provider diagnoses the cause of the pain, you can find the best treatment for managing it. 

Treatments and Management of Back Pain

Treating chronic back pain can be difficult, whether it’s from lung cancer or another cause. You will probably need to use more than one kind of treatment to get lasting relief.

You may want to start with some at-home treatments for back pain, such as:

• Working on your posture
• Staying hydrated and eating a nutritious diet
• Avoiding twisting and bending at the waist (especially if you’re lifting)
• Getting regular physical activity, limiting sedentary time, and working on developing muscle strength (especially in your core)
• Make changes (like getting a new mattress or pillow) to improve your sleep
• Achieving and maintaining a weight that supports your health
• Resting and using ice and heat treatments

Medical treatments for chronic back pain may include a combination of over-the-counter and prescription medications, as well as physical therapy. For example, your provider may have you try:

• Non-steroidal anti-inflammatories like ibuprofen 
• Prescription pain medications like tramadol
• Prescription medications that relax your muscles 
• Topical creams or patches 
• Steroid shots
• Shots that numb your spine
• Antidepressant and/or anticonvulsant medications
• Working with a physical therapist on exercises that help strengthen your body

If you have back pain from lung cancer and pressure from a tumor is causing pain, your provider will go over the possible treatments which may include:

• Surgery
• Chemotherapy
• Targeted therapy
• Immunotherapy
• Radiation therapy

If cancer has spread to your bones, you may need to have radiation therapy along with taking drugs called bisphosphonates that treat osteoporosis. A drug called denosumab also provides pain relief and reduces the risk of fractures in affected bones.

Along with lifestyle changes and medical treatment, you may want to ask your provider about alternative therapies for back pain, like chiropractic care, massage therapy, yoga, acupuncture, or pilates.

Summary

Back pain can be a sign of lung cancer, and might be the first symptom you have. However, it’s more likely that your back pain is being caused by something more common, like kidney stones or muscle strain.

When back pain is from lung cancer, it’s usually caused by a tumor pressing on spinal nerves and vertebrae. Back pain from lung cancer does not get better with rest and is often worse when you’re laying down or when you take a deep breath.

If your back pain is not getting better with at-home treatments, call your provider. If it is from lung cancer, the sooner you can get diagnosed and start treatment, the better.

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.