Could My Back Pain Be Spine Cancer?

For people who have severe back pain, it is natural to wonder whether or not the pain might be a sign of spinal cancer. While most back pain is unrelated to cancer or tumors, it is possible and important to check out. This article explains when back pain may be related to a spinal tumor, how to get an accurate diagnosis, and what to consider for treatment options.

Types of Spinal Tumors

A spinal tumor is an abnormal growth of cells within the spinal column. These tumors may be cancerous (malignant) or noncancerous (benign). A cancerous tumor is composed of abnormal cells that continue to divide uncontrollably and have the potential to spread via the blood or lymphatic system.

There are 2 general types of spinal tumors:

• Primary tumors originate in the spinal column. While most primary tumors are noncancerous, some are cancerous.
• Secondary tumors, also called metastatic tumors, have spread to the spine from another part of the body. Metastatic tumors are cancerous. About 90% of diagnosed spinal tumors are metastatic.¹Ziu E, Mesfin FB. Cancer, Spinal Metastasis. [Updated 2019 Apr 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441950/.^,2Ciftdemir M, Kaya M, Selcuk E, Yalniz E. Spinal tumors of the spine. World J Orthop. 2016; 7(2): 109-116. doi: 10.5312/wjo.v7.i2.109.

Spinal tumors can also be classified by whether they are outside the spinal cord (extradural), within the spinal cord’s protective covering (intradural-extramedullary), or within the spinal cord itself (intramedullary).

How Spinal Cancer Pain May Feel

When back pain is caused by a cancerous spinal tumor, it typically:

• Starts gradually and worsens over time
• Does not improve with rest and may intensify at night
• Flares up as a sharp or shock-like pain in the upper or lower back, which may also go into the legs, chest, or elsewhere in the body

Other signs and symptoms that could potentially indicate the origin of back pain from cancer include unplanned weight loss, nausea, fever, chills, or other troubling symptoms.

How Spinal Cancer May Cause Back Pain

Tumors in the spinal column may cause back pain by:

• Expanding and/or weakening the bone
• Causing the vertebrae to easily fracture
• Compressing the spinal cord and/or spinal nerve roots

Additional factors, such as spinal instability, may also be involved in spinal tumors causing back pain.

The Course of a Cancerous Spinal Tumor

Cancer is more likely to occur with age.³Xu Z, Taylor JA. Genome-wide age-related DNA methylation changes in blood and other tissues relate to histone modification, expression and cancer. Carcinogenesis. 2014; 35(2):356-64. doi: 10.1093/carcin/bgt391. People who are older than age 50 or previously had cancer are at an increased risk of developing a cancerous spinal tumor.¹Ziu E, Mesfin FB. Cancer, Spinal Metastasis. [Updated 2019 Apr 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441950/.

A cancerous spinal tumor’s rate of growth can vary depending on the type. A tumor may be relatively small and contained within the spine, or it could have already spread through blood or lymph (fluid that travels throughout the body) from another area of the body. An untreated cancerous spinal tumor is likely to keep growing and may become life-threatening.

Treatment options for spinal cancer may include radiation therapy, chemotherapy, immunotherapy, and/or surgical removal of the tumor. In cases when the patient is unlikely to tolerate surgery well or has advanced cancer, palliative care may be offered to reduce pain and stay as comfortable as possible, rather than removing the tumor.

Read about Metastatic Spinal Tumor Treatment

When to See a Doctor

When unexplained back pain persists for a couple weeks despite rest and/or self-care, it is typically recommended to visit a doctor for a medical evaluation. Severe back pain that interferes with daily activities, or any back pain that is accompanied by red flag symptoms such as nausea or weight loss, requires an immediate medical evaluation. For people who currently have or previously had cancer, any new back pain needs to be evaluated by a doctor immediately.

See When Back Pain May Be a Medical Emergency

It is also important to note that back pain rarely turns out to be cancer. Getting an accurate diagnosis for back pain from a medical professional is an important first step toward finding an effective treatment plan.