Understanding Back Pain


Could My Back Pain Be the Result of Cancer or a Tumor?

Many patients with acute or chronic back pain wonder whether it might be related to cancer or a tumor, especially if the pain is severe.  Tumors and neoplasms in the spine or spinal column may cause pain from expansion of bone and/or weakening of bone. This may result in a pathological spinal fracture, spinal instability, or compression (pinching) of the spinal cord or spinal nerves. Fortunately cancer or tumors in the spine are rare.

Most back pain is not caused by cancer or a tumor although many of the signs and symptoms associated with a spinal tumor are similar to those that arise from more common spinal problems. This is particularly true during the earlier stage of tumor development. The following signs and/or symptoms may be associated with a spinal tumor:

  • Progressive pain in the neck or back associated with neurological problems such as muscle weakness, or numbness of the arms or legs or a change in normal bowel or bladder habits.
  • Back pain along with a combination of other symptoms such as such as a loss of appetite, unexplained weight loss, nausea, vomiting, fever or chills.
  • Pain that does not improve during  rest
  • Pain which is greater at night than during the day. 
  • Significant localizing pain associated with direct manipulation or compression of the affected area of the spine
  • Progressive back pain intensity in a patient with known cancer or a history of cancer.

Tumors that originate in the spine are referred to as primary tumors and are rare.  Primary spinal tumors tend to occur more frequently in younger individuals and are often slow growing and benign.  Most spinal tumors represent spread (metastasis) from primary tumors from other areas of the body.  Individuals who have a history of cancer or who develop unexplained spine complaints, especially those with related neurological problems should be evaluated to determine the cause of their back or neck complaints and to rule out spread to the spine.

Tumors are classified by their appearance, their location as well as their shape and size. They can be further typed or classified by tissue analysis after resection or biopsy. They may develop in the vertebral column (vertebral column tumors), within the confines of the spinal membranes (dura) and outside the spinal cord (intradural-extramedullary), or within the spinal cord or nerves (intramedullary).  In women, spinal tumors most frequently spread from cancer that originates in the breast or lung.  In men, spinal tumors most frequently spread from cancer that originates in the prostate gland or the lung.