What is back pain with cancer?
Low back pain is a common occurrence and is rarely a sign of cancer. However, there is less risk of back pain associated with cancers such as spinal, colorectal, or ovarian cancer. A person with this type of cancer may have other symptoms in addition to low back pain.
According to the National Institutes of Health, 80 per cent of people in the United States experience low back pain in their lifetime. Common causes of low back pain range from heavy lifting to injury, age-related spinal changes, and injuries like a fall or a car accident.
Lower back cancer is very rare in some people. Cancer-associated low back pain is more likely to be related to a tumor in the surrounding area (such as the colon) than to cancer in the back. Spinal cord tumors can be classified into one of three different types based on the protective layers of the spinal cord and where they occur.
The main types of intradural tumors are:
- Intramedullary tumors begin in cells of the spinal cord, such as gliomas, astrocytomas, or ependymomas.
- Extramedullary tumors grow on the membrane that surrounds the spinal cord or on the nerve roots that come from the spinal cord. Although they do not originate in the spinal cord, these types of tumors can affect the function of the spinal cord by causing compression of the spinal cord and other problems. Examples of tumors affecting the spinal cord are meningiomas, neurofibromas, and neuronal tumors.
Tumors from other parts of the body can spread to the vertebrae, the supporting network around the spinal cord, or, in rare cases, to the spinal cord (metastasis).
Spinal tumors or any growth can cause pain, nerve problems, and sometimes paralysis. The spinal tumor can be malignant and cause permanent disability. Spinal tumor treatment may include surgery, radiation therapy, chemotherapy, or other medications.
Symptoms of back pain with cancer
Spinal cord tumors cause different signs and symptoms, especially as the tumors grow. Tumors can affect the spinal cord or nerve roots, blood vessels, or the spinal cord. Signs and symptoms of back pain with cancer may include:
- Pain at the tumor site due to tumor growth.
- Back pain, which often radiates to other parts of your body
- You feel less sensitive to pain, heat, and cold.
- Loss of bowel or bladder function.
- Difficulty walking, sometimes leading to a waterfall.
- Pain at night is worse
- Especially loss of sensation or muscle weakness in the arms or legs.
- Muscle weakness, which can be mild or severe in various parts of the body.
- Back pain is an early symptom of spinal tumors. The pain can spread beyond the back to the hips, legs, feet, or arms and get worse over time, even with treatment.
- Spinal tumors progress at different rates depending on the type of tumor.
Types of cancer that cause back pain
Many types of cancer in and around the spine can cause low back pain. In addition to:
- Spinal tumor: The spinal tumor can grow in the spinal cord or the protective layers around the spinal cord. The spine is a common source of bone metastasis, where cancer begins in one place and spreads to others. The American Association of Neurological Surgeons (AANS) estimates that 30 to 70 percent of people with cancer have cancer that has spread to any part of the spine.
- Lung cancer: AANS reports that lung cancer is one of the most common cancers that spread to the spine. Pulmonary lung tumors can also press on the spine and affect nerve conduction to the back. A person with lung cancer may experience symptoms such as little fatigue, shortness of breath, and low back pain, as well as a cough with clotted sputum.
- Breast cancer: Back pain is a rare but possible symptom of breast cancer. According to AANS, breast cancers generally metastasize backward. Similar to lung cancers, some breast cancer tumors can also put pressure on the nerves that travel to the spine. Causes pain.
- Esophagus or gastrointestinal tract: Cancers of the stomach, colon, and rectum can cause low back pain. This pain radiates from the cancer site to the lower back. A person with this type of cancer may have sudden weight loss or other symptoms such as blood in the stool.
- Blood and tissue: Blood and tissue cancers such as multiple myeloma, lymphoma, and melanoma can cause low back pain.
Risk factors for back pain with cancer
Spinal cord tumors are more common in people with:
- Neurofibromatosis 2: In this inherited disorder, benign tumors develop on or near the auditory nerve. This can lead to progressive hearing loss in one or both ears. Some people with neurofibromatosis 2 also develop tumors of the spinal canal.
- Von Hippel-Lindau disease: This rare multisystem disorder is associated with vascular tumors (hemangioblastomas) in the brain, retina, and spinal cord, and with other types of tumors in the kidneys or adrenal glands.
Back pain with cancer diagnosis
Your doctor will examine your symptoms and medical history when diagnosing the causes of low back pain. It is important to include whether you have a history of cancer or a family history of cancer.
Since cancer is a very rare cause of low back pain in those who do not already have it, the doctor may recommend other treatments before whole cancer works.
However, if pain persists after physical therapy or anti-inflammatory medication, the doctor may order imaging studies and blood tests. These tests can help find out if there are signs of cancer-causing low back pain.
Back pain with cancer treatment
The treatments your doctor prescribes for your back pain will depend on the type of pain you have, how much it hurts, and the cause.
Pain alone: If your back pain has just started or is slowly getting worse, your doctor may recommend an over-the-counter medicine,
If the pain is severe, your doctor may prescribe an opioid.
The bone is damaged: If your lung cancer spreads to the bones in your spine and causes damage there, your doctor may prescribe special medications to treat bone pain while helping to strengthen your bones. These medications include:
- Zoledronic acid (Zomata)
Pain-related to the tumor: To treat your back pain, your doctor may need to treat back pain with cancer that has spread from your lungs to your spine. This treatment may include:
- Radiation therapy to shrink a tumor in the spine
- Surgery to repair or strengthen your bones
High calcium levels: If you have high calcium levels, your doctor may recommend:
- Drink more water
- Keep fluids in the vein
- Take medications that lower your calcium levels.
- Palliative care
You can ask your doctor to recommend an expert in palliative care. They can help you manage cancer-related side effects.
A palliative care specialist may suggest considering some of these options in addition to or in addition to pain relief:
- Weeding the back
- Changes in your diet
- Exercise, stretching, and physical therapy
- Relaxation techniques like meditation and yoga.
- Nerve blocks
Medical treatments for lower back pain related to cancer depend on the type of cancer and how advanced the cancer is.
For example, sometimes a doctor will recommend surgery to remove a tumor. Other treatments may include chemotherapy and radiation to shrink a tumor.
Doctors may also prescribe pain medications to help reduce the painful effects. Muscle relaxants may also help reduce the incidence of muscle spasms that can further worsen back pain.
At-home treatments for lower back pain related to cancer may include:
- Cold or heat: Applying cloth-covered ice packs or heat packs to the lower back for 10 to 15 minutes can provide relief.
- Over-the-counter pain relievers: Taking over-the-counter pain relievers, such as ibuprofen or naproxen, can help. Always check with your doctor first to ensure there won’t interfere with other medications you’re taking.
- Movement: Gentle exercise may help keep back muscles strong and flexible. Examples of gentle exercise include walking and stretching.
Back pain with cancer complications
Spinal tumors can contract the spinal nerves, causing loss of movement or sensation below the location of the tumor. It can sometimes cause changes in the function of the intestines and bladder. Nerve damage can be permanent.
However, if caught early and treated aggressively, nerve function can be restored without losing more function. Depending on its location, a tumor pressed against the spinal cord can be malignant.
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.
People should seek immediate medical attention if their lower back pain is severe, or occurred as a result of an injury.
To diagnose the cause of the lower back pain, a doctor will ask about a person’s symptoms and medical history. They may also order imaging tests to check for abnormalities of the bones, joints, and other structures within the spine.