There are many causes of back pain. In some cases, this common complaint could be due to minor injuries or strains. And while back pain may not be one of the first symptoms that come to mind as an indicator of lung cancer, the Roy Castle Lung Cancer Foundation notes that it could be just that.

If you are experiencing long-term back pain, you may want to consider if you have any co-occurring symptoms that could also be signs of lung cancer. Other common symptoms include respiratory issues, like hoarseness, coughing up blood (hemoptysis), and shortness of breath (dyspnea), as well as irregular head, shoulder, or chest pain. If you are experiencing back pain that persists for longer than a few days, it’s always best to connect with your health care team.

What Causes Back Pain in Lung Cancer?

As lung cancer progresses, two possible developments may produce back pain: lung tumors and metastasis (the spread of lung cancer to other parts of the body).

Lung Tumors

When a lung tumor grows in size, it begins to compete for space with the surrounding bones, tissues, and nerves. Pain may develop depending on the tumor’s location and the pressure it exerts. Tumors that exert pressure on the chest wall and the pleura (membrane lining the lungs) are known to cause back pain or chest pain.

Pancoast Tumor

Occurring in 3 percent to 5 percent of all cases of lung cancer, a Pancoast tumor (also called a superior sulcus tumor) is a rare form of non-small cell lung cancer that originates in the topmost part of the lungs. Pancoast tumors usually do not cause respiratory issues typical of other lung cancers. Instead, these tumors expand upward from the top of the lung and begin to hinder the nerves around the shoulders and shoulder blades, causing sharp shoulder pain, among other symptoms. Depending on the Pancoast tumor location, different upper body areas can experience pain.

Bone Metastasis

In people with metastatic lung cancer (advanced lung cancer), the cancer cells from the primary tumor have spread out into neighboring parts of the body. In most cases, lung cancer cells enter the surrounding bones in a process called bone metastasis. As cancer cells begin to invade the bone, the cells alter the bone’s structure. Small holes, called lytic lesions, then develop on the affected bones and can cause severe pain in the back, shoulders, and chest.

Metastasis to the spine can also result in spinal cord compression. When that happens, symptoms such as back pain, weakness, numbness, and even paralysis can occur. Though uncommon, it is possible for bone metastasis and spinal cord compression to be the only presenting symptoms of a person’s lung cancer.

Most of the physical symptoms of lung cancer do not surface until the tumor metastasizes. However, researchers are working to find new methods of early detection. By better understanding the link between lung cancer and back pain, it may be possible to discover lung cancer in its early stages.

Leptomeningeal Metastasis

One particular form of metastasis, known as leptomeningeal metastasis, refers to the spread of cancer to the membranes that line the spinal cord and brain. This type of metastasis is rare, diagnosed in 1 percent to 5 percent of those who develop solid tumors. One case study published in the Journal of the Advanced Practitioner in Oncology reported that a woman with leptomeningeal metastasis developed severe lower back and leg pain as a result of her cancer.

What Does Back Pain in Lung Cancer Feel Like?

Because lung cancer tumors manifest in many different forms and locations, it is difficult to put a general description on the back pain caused by lung cancer. Some people with metastatic lung cancer have described upper or lower back pain that radiates outward, sometimes accompanied by feelings of numbness or weakness in the legs. Some people have also noted that they experience a tingling sensation racing down their legs alongside back pain, signifying nerve involvement or leptomeningeal metastasis.

Managing Back Pain With Lung Cancer

Managing back pain related to lung cancer often starts with treating the lung cancer itself. If treatment does not relieve your acute pain, your oncologist or health care team may recommend other options such as over-the-counter or prescription pain relievers to help manage your discomfort.

As with any new or worsened symptoms, contact your health care team if you start experiencing back pain. Make sure to reach out if this pain is causing sleep disruptions or hindering your everyday life.

Treating Lung Cancer

Treating the underlying cancer may help manage symptoms like back pain. In the case of an intruding lung tumor, for example, the pressure the tumor was applying on the surrounding nerves will typically go away as the tumor shrinks.

The type of lung cancer treatment an oncologist recommends will typically depend on the stage and the type of lung cancer you have. In the early stages of lung cancer, it may be possible to remove the tumor surgically. If the tumor has begun to spread, your doctors may suggest chemotherapy or radiation therapy sessions.

Medication for Pain Relief

Over-the-counter pain relievers, like nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, may help mitigate mild or moderate back pain caused by lung cancer. That said, always ask your doctor if these painkillers are safe in your particular situation. For more severe back pain, your doctor may prescribe stronger medications, including morphine or other opioids. Talk with your health care team to understand what pain relief medications you can take with your cancer treatment.

Hot and Cold Treatments

Ice therapy is mainly used to treat swelling and inflammation of acute pain, while heat therapy reduces tension and increases your flexibility. If your back pain strikes without warning, try to use cold therapy. Penn Medicine recommends applying ice for 15 minutes and then leaving the area bare for another 15 minutes. (Wrap the ice or cooling pack to avoid placing either on bare skin.) If the pain continues after 48 to 72 hours, try applying heat instead.

Find Your Team

On MyLungCancerTeam, the social network for people with lung cancer and their loved ones, more than 5,000 people from around the world come together to ask questions, offer support and advice, and connect with others who understand life with lung cancer.

Have you experienced back pain during your diagnosis? How have you learned to manage it? Share your story and tips in the comments below or by posting on MyLungCancerTeam.