Lung cancer can cause pain in the back, especially when the tumor has spread to other parts of the body.1 Cancer treatments and pain management strategies can help relieve pain and improve overall quality of life.

What Causes It?

You may experience pain in your back if you have lung cancer for several reasons.2 

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).3

When cancer cells spread to the spine, you can experience excruciating back pain that may require pain medications.3 

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.4

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.5

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.5

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.6 

Soft tissue metastasis is often a sign of advanced-stage lung cancer.7

Other Causes

There are other possible causes of back pain in people with lung cancer, including:2

• Pain from the lungs that radiates to the back 
• Symptoms of infections, which commonly occur in people with cancer due to a weakened immune system
• Chronic (long-term) inflammation
• A backbone fracture due to bone weakness that occurs when cancer spreads to the spinal bones

What Does It Feel Like?

Determining if your back pain is connected to lung cancer can be difficult without seeing a doctor. More common culprits of back pain include muscle sprains and poor posture.

Some distinct characteristics or warning signs that your back pain could be due to lung cancer include:43

• 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
• Persistent, non-relenting pain at a single site
• Neck pain that occurs alongside back pain
• Aches that progress to a loss of motor function, which may cause leg weakness or trouble walking

Other Lung Cancer Symptoms To Watch For

Back pain may point towards lung cancer if it is accompanied by other symptoms like:1

• 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.895

How Do You Treat This 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. 

They may recommend the following treatments to destroy cancer cells and improve your symptoms:3

• Chemotherapy or radiation therapy: These may help shrink your tumor and reduce the number of cancer cells in your body.
• Steroids: Medications like Decadron (dexamethasone) may help reduce pain.
• Spinal surgery: This may improve back pain and reduce the risk of complications like paralysis.
• Bisphosphonate drugs: Treat brittle and fragile bones in your back by administering medications like Aredia (pamidronate) or Zometa (zoledronic acid) into your veins.4
• Over-the-counter (OTC) pain medication: Examples like Advil (ibuprofen) and Tylenol (acetaminophen) may relieve mild pain.
• Prescription pain medications: Narcotics or muscle relaxers may reduce symptoms of chronic or severe back pain.10

How Can You Manage It?

Certain lifestyle modifications and home remedies may help you manage chronic back pain. Consider the following tips:2

• 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 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 Should You See a Healthcare Provider?

If you experience sharp, shooting pain or chronic back pain that suddenly worsens, it's important to seek medical attention.

Reach out to a healthcare provider urgently if your pain occurs alongside symptoms like muscle weakness or numbness, fatigue, and chest pain.

Edited by   Sukhman Rekhi