Why Does Lung Cancer Cause Back Pain?

Lung cancer is hardly what comes to mind when you experience back pain. However, evidence indicates that the back is one of the most common sites in the body where people with lung cancer experience pain. 

While it’s not often listed as a common symptom of lung cancer, the American Cancer Society notes that lung cancer can cause pain in the back, especially when the tumor has spread to other parts of the body.

When lung cancer spreads to the spine—in about 19% of spinal metastasis—pain can occur in the back. If a nerve is involved, you might also experience a sharp, shooting pain that travels through specific areas of skin connected to a spinal nerve.

The severity of back pain in people with lung cancer can range from mild to debilitating. However, cancer treatments and pain management strategies can help improve symptoms and overall quality of life.

Symptoms and Characteristics

Until you see a healthcare provider, it can be hard to determine if your back pain is connected to lung cancer. It's worth noting that not all back pain is due to cancer. Several other factors, like a muscle sprain or improper posture, are common culprits of back pain.

However, there are some distinct characteristics or warning signs that could indicate that your back pain is associated with lung cancer, such as:

• Back pain that worsens at night and disrupts sleep
• Discomfort that feels like a deep, aching pain
• Pain that radiates from the back down to one or both legs
• Neck pain that occurs alongside back pain
• Aches that progress to a loss of motor function, which may cause leg weakness or trouble walking
  

Back pain may also point towards lung cancer if it is accompanied by other symptoms like:

• Chronic cough
• Chest pain
• Shortness of breath
• Wheezing
• Coughing up blood
• Fatigue
• Unexplained weight loss

Lung cancer can cause pain in any area of the back, but many people experience lower back pain with lung cancer. The severity of the pain will also vary depending on what stage of cancer you're in and how fast your condition is progressing.

Potential Causes

People can experience back pain for various reasons, including injuries, musculoskeletal problems, and poor posture.  However, there are several reasons why you may experience pain in your back if you have lung cancer.

Spinal Metastasis

Sometimes, lung cancer spreads to the spinal column (known as spinal metastasis). Healthcare providers often detect them as bone metastasis (cancer that spreads to the backbones of the spine). They commonly occur in the thoracic region (the mid-section of the spine), followed by the lumbar region (lower back).

When cancer cells spread to the spine, you can experience excruciating back pain that may require pain medications. 

Spinal Compression

The growth and spread of lung cancer can press on the spinal cord, the bones of the spine, or nerves as they exit from the spinal cord. This pressure can irritate the nerves, which can cause pain in the back or neck.

Leptomeningeal Metastasis

Leptomeningeal metastasis occurs when lung cancer has spread into the fluid surrounding the brain and spinal cord (known as cerebrospinal fluid) and the thin tissue layers (called the meninges) that surround and protect your central nervous system.

Leptomeningeal metastasis occurs in 1-5% of people with solid tumors and is commonly diagnosed in people with lung cancer. When the tumor spreads into the leptomeninges around the lumbar spine, it can cause lower back and leg pain.

Soft Tissue Metastasis

In rare cases, lung cancer may spread to the body's soft tissues, including the skin, muscles, tendons, and ligaments. For instance, lung cancer that spreads to the psoas muscle—a long, ribbon-shaped muscle on either side of the lower spine—may cause lower back pain. 

Soft tissue metastasis is often a sign of advanced-stage lung cancer.

Other Causes

There are other possible causes of back pain in people with lung cancer, including:

• Pain from the lungs that radiates to the back 
• Symptoms of infections, which commonly occur in people with cancer due to weakened immune system
• Chronic inflammation
• Backbone fracture due to bone weakness that occurs when cancer spreads to the spinal bones
  

How To Treat Lung Cancer Back Pain

Treatment for lung cancer back pain depends on the particular structure affected and the direct cause of the pain. Your healthcare team will often start by performing a physical examination, asking questions about your symptoms, and recommending tests to understand what is causing your pain. 

Once they learn more about your symptoms and overall condition, they may recommend the following treatments to destroy cancer cells and improve your symptoms:

• Chemotherapy or radiation therapy: Helps shrink the size of your tumor and reduce the number of cancer cells in your body
• Steroids: Reduce pain and improve symptoms via medications like Decadron (dexamethasone)
• Spinal surgery: Improves back pain and reduces the risk of complications like paralysis
• Bisphosphonate drugs: Treats brittle and fragile bones in your back by administering medications like Aredia (pamidronate) or Zomeda (zoledronic acid) into your veins
• Over-the-counter pain (OTC) medication: Relieves mild pain through medications such as Advil (ibuprofen) and Tylenol (acetaminophen)
• Prescription pain medications: Uses medications like narcotics or muscle relaxers to reduce symptoms of chronic or severe back pain
  

How To Manage the Pain

Chronic back pain can be challenging to treat, whether it’s caused by lung cancer or any other cause. It is, in fact, one of the most common reasons people seek emergency care. Certain lifestyle modifications and home remedies may help you manage it. Consider the following tips:

• Avoid activities that tend to worsen your pain
• Improve your posture through exercises
• Get enough sleep
• Use ice and heat therapy to relieve pain
• Maintain a weight that's right for you
• Try techniques like yoga and deep breathing exercises for relaxation
• Ask your healthcare provider about complementary therapies like acupuncture, massage, and chiropractic care
• Receive support from a physical therapist, who may recommend braces or exercises that relieve pain
  

When to Contact a Healthcare Provider

If you experience sharp, shooting pain or chronic back pain that suddenly worsens, it's important to seek medical attention to understand what's causing your pain. You should reach out to a healthcare provider urgently if your pain occurs alongside symptoms like muscle weakness or numbness, fatigue, and chest pain.

Back pain is a symptom of several medical conditions, including lung cancer. Your healthcare provider will conduct thorough testing to learn if your back pain is due to lung cancer or another underlying condition. This helps you and your provider understand what treatments can effectively relieve your pain.

A Quick Review

Back pain is a common health complaint but is often an unexpected symptom of lung cancer. Specifically, if lung cancer cells spread to the spine, pain can radiate to your back and other parts of your body. Back pain with one or two accompanying symptoms does not necessarily mean you have lung cancer. Poor posture or muscle sprains can also cause back pain.

If your pain persists or doesn't get better with medications, seeing a healthcare provide for a proper diagnosis can help you understand what's going on and which treatments can offer relief.