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Back Pain as a Symptom of Lung Cancer

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Updated March 31, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

It’s not uncommon for people to experience back pain with lung cancer, or even have back pain as their first symptom of lung cancer. Of course, there are many causes of back pain that are more common than lung cancer. In addition, back pain in people with lung cancer may be related to their cancer, or another cause such as arthritis. What causes back pain with lung cancer, and how does the pain differ from other causes of back pain?

Why Does Lung Cancer Cause Back Pain?

There are several ways in which lung cancer can cause back pain. The tumor alone may contribute to back pain by creating direct pressure on structures in the back. The cancer may also irritate nerves traveling through the chest or the lining of the lungs which can be interpreted by the brain as back pain.

Back pain also may be caused by the spread (metastasis) of lung cancer to bones in the spine, or adrenal glands, small glands in the abdomen near the top of the kidneys. Roughly 30 to 40% of people with lung cancer experience the spread of cancer to their bones at some time during their illness.

How is Back Pain From Lung Cancer Different from Other Causes of Back Pain?

Back pain related to lung cancer is often described as pain occurring in the mid to upper back. Unfortunately, back pain due to lung cancer can be very similar to other causes of back pain, and it is important to talk with your doctor if you are experiencing back pain.

That said, back pain that is present along with other symptoms of lung cancer may be more concerning. These may include a persistent cough, coughing up blood, shortness of breath, or general symptoms such as fatigue or unexplained weight loss. Other symptoms that may be of concern include back pain that is present at rest or at night, that occurs without any activity, or is worse when you take a deep breath.

Lung cancer that is first noticed as back pain is often diagnosed after treatments such as physical therapy fail to make the pain go away. If you have pain that is persisting despite treatment be sure to make your doctor aware so she can recommend further evaluation.

How Common is Back Pain With Lung Cancer?

It isn’t known how often back pain is the first symptom of lung cancer, though 25% of people have bone pain of some form at the time of diagnosis. During the course of the disease many people will experience back pain of some type.

Treatment of Back Pain Related to Lung Cancer

The treatment of back pain related to lung cancer depends upon the underlying cause. If the pain is related to pressure from the tumor, treatments to decrease the tumor size such as surgery, chemotherapy, or radiation therapy may be considered. If bone metastases are present and causing pain, treatment to address the spread of lung cancer to bone is important.

Sources:

Beckles, M. et al. Intial Evaluation of the Patient With Lung Cancer: Symptoms, Signs, Laboratory Tests, and Paraneoplastic Syndromes. Chest. 2003. 123(no 1 suppl):97S-104S.

National Cancer Institute. Fact Sheet. Metastatic Cancer: Questions and Answers. Updated 9/01/04. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic

Ross, M. and E. Bayer. Cancer as a cause of low back pain in a patient seen in a direct access physical therapy setting. Journal of Orthopedic and Sports Physical Therapy. 2005. 35(10):651-8

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