Lung Cancer Back Pain – What it Feels Like & Treatment

When diagnosed with or going through treatment for non-small cell lung cancer (NSCLC), you might experience some level of back pain or discomfort. According to the Dana-Farber Cancer Institute, approximately 25% of people with lung cancer experience back pain, sometimes even before they’ve officially been diagnosed with NSCLC. 

In those cases, the uncomfortable back pain can come from a tumor putting pressure on the muscles and organs surrounding the lungs, causing pressure on the spine. In some cases, back pain is the first symptom of NSCLC. 

NSCLC-related back pain is usually accompanied by additional symptoms of lung cancer, including:

• A persistent cough for more than 2 weeks
• Shortness of breath, hoarseness or wheezing
• Chest pain when breathing
• Recurring chest infections
• Coughing up blood 
• Fatigue
• Headache
• Swelling in the neck or face
• Loss of appetite and unexpected weight loss
• Chronic pneumonia or bronchitis 

If you’re experiencing back pain related to your cancer, be sure to talk to your care team about therapies that might help with the pain. 

Your back pain could worsen as the cancer spreads. 

Your doctor might order a test to look more closely at the bones in your back when you’re experiencing pain, such as an X-ray, CT scan, MRI, or PET scan. Blood tests to check your calcium levels might also help indicate if you have one or more of the following diagnoses:

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• Spinal cord compression: When the cancerous tumor spreads, it can put uncomfortable pressure on your spinal cord and the nerves around your spine. When this happens, the pain can spread to your arms and legs and cause other parts of your body to feel numb, weak, or stiff. 

• Leptomeningeal metastasis: If your cancer spreads into the tissue and fluid that covers your spinal cord and brain it can cause back pain, as well as headaches and weakness in your extremities. 

• Increased calcium levels: If your lung cancer has spread to your bones, your calcium levels can rise and cause hypercalcemia, resulting in nausea, vomiting, thirst, headaches, and weakness in your extremities. Your doctor might recommend you drink more water or prescribe a drug to bring your calcium levels back to normal. 

NSCLC treatment can also cause back pain. While the pain might occur as an immediate symptom during treatment, it’s possible it could worsen at any point during treatment or even afterward. 

Your doctor might recommend a palliative care expert to help you manage the pain. Treatments could range from regular exercise and stretching to one or more of the following list of therapies:

• Medication (either opioid or non-opioid)
• Antidepressants
• Physical therapy
• Braces
• Acupuncture
• Yoga
• Mediation
• Nerve Blocks 
• Surgery

If you haven’t been diagnosed with NSCLC but experience any of these symptoms with sudden and constant back pain, contact your care provider immediately.

If you would like to talk more about back pain or any other side effects you can connect with an Outcomes4Me oncology nurse practitioner at no charge through the Outcomes4Me app, using the “Ask Outcomes4Me” button.

Frequently Asked Questions

Is back pain a common symptom of NSCLC?

Back pain can happen in people with NSCLC, but it is not always caused by the cancer itself. Many people experience back pain from muscle strain, posture changes, stress, or other non cancer causes. Still, any new or persistent pain should be discussed with your care team.

Can NSCLC cause back pain without spreading?

Yes. NSCLC can sometimes cause back pain even without spread, especially if a tumor irritates nearby nerves or tissues in the chest, upper back, or shoulder area. Pain can also come from coughing, reduced activity, or treatment side effects.

When should I worry about NSCLC back pain?

Contact your care team if NSCLC back pain is new, worsening, persistent, or wakes you up at night. Seek urgent care if back pain comes with weakness, numbness, trouble walking, or loss of bladder or bowel control.

How do doctors check if back pain is related to lung cancer?

Your doctor may start with a physical exam and symptom history, then order imaging such as a CT scan, MRI, or bone scan if there is concern about spread to the bones or spine.

What are treatment options for back pain in NSCLC?

Treatment depends on the cause. Options may include pain relievers, anti inflammatory medicines, physical therapy, treatment for the cancer itself (such as radiation for bone pain), and supportive care approaches like heat, stretching, or guided exercise.

Can treatment for NSCLC cause back pain?

It can. Some people develop muscle stiffness, weakness, or joint pain from reduced movement, stress, or certain treatments. Tell your clinician what you are feeling so they can help you manage symptoms safely.