Oncologist says ‘persistent back pain’ can be early warning sign of lung cancer; shares when you should worry

Back pain is one of the most common health complaints and is usually linked to strain, poor posture, or lifestyle habits. However, experts caution that in some cases, it could point to something more serious. HT Lifestyle has reached out to experts to know the possible hidden causes of persistent back pain, including when it may signal underlying conditions such as lung cancer. (Also read: Oncologist says ‘men over 50’ should never ignore these early warning signs of prostate cancer )

Back pain and lung cancer: When to worry

“Back pain is a day-to-day complaint often invariably linked to heavy lifting, posture issues or ageing, mattress issues, which are usually relieved with OTC pain killers, muscle relaxants, but when it persists, then you need to think. It can be an early indicator of cancer. Lung cancer is a disease characterised by uncontrolled, unregulated, unchecked growth of cells in the lungs, which might spread to other parts of the body, including the axial system (spine, pelvis and other bones), causing back pain,” says Dr. Sunny Jain, Sr. Consultant and HOD, Oncology, Accord Super Speciality Hospital, Faridabad NCR.

As per a 2024 study by H. Haryati et al., in advanced non-small cell lung cancer (NSCLC), 30–40% of patients develop bone metastases, with vertebral involvement being among the most common, often leading to spinal cord compression. Research suggests that lung cancer accounts for about 15% of all cases of cancer-related cord compression. Pain is also a frequent complaint among lung cancer patients.

For instance, a Canadian study involving over 13,000 stage IV NSCLC patients reported pain in approximately 68.5% of cases. Similarly, another study that enrolled 533 lung cancer patients found that nearly 240 patients (45%) experienced pain during the course of their disease.

Warning signs that should not be ignored

According to Dr. Sunny, here’s when you should worry:

• If you have constant, deep, and worsening pain at night or during rest that is not relieved by routine treatments like physiotherapy or painkillers.

• If the pain is accompanied by other warning signs of lung cancer, such as chronic cough, unexplained weight loss, loss of appetite, breathlessness, or coughing up blood.

Early diagnosis of lung cancer can greatly improve outcomes. As the saying goes, “Eyes cannot see what the mind doesn’t know.” So, keep your eyes and mind open, stay informed, stay fit, and don’t hesitate to see your doctor if needed.

How lung cancer can cause back pain

“When lung cancers grow, they sometimes invade nearby structures or spread to the bones, especially the spine,” explains Dr Kamran Ali, Principal Consultant, Lung Transplant and Thoracic Surgery, Max Super Speciality Hospital, Saket, New Delhi.

“Tumours can irritate nerves, compress vertebrae, or put pressure on ribs. Pancoast tumours near the lung apex may affect nerves running through the shoulder and upper back, causing pain. Once cancer reaches the bones, the pain may worsen at night, resist painkillers, and progressively increase,” Dr Kamran.

While most back pain is harmless, you should seek medical advice if you notice:

• Pain that is persistent, lasting more than a few weeks, especially new or worsening upper back pain.
• Pain that doesn’t improve with rest, physiotherapy, or usual care.
• Pain with other lung cancer warning signs — chronic cough, coughing up blood, shortness of breath, unexplained weight loss, or fatigue.
• Shoulder pain, hoarseness, arm swelling or numbness, which may indicate tumour involvement of nerves.

Unfortunately, lung cancer is often diagnosed late in India, when treatment options are limited and outcomes poorer. Early diagnosis can allow for surgery, targeted therapies, and better survival rates.

As Dr Sunny points out, “Eyes cannot see what the mind doesn’t know. Awareness about less obvious symptoms like back pain can make the difference.”

If you or someone you know has persistent back pain combined with respiratory symptoms or unexplained weight loss, don’t ignore it. Consult a doctor for:

• A detailed history and physical examination
• Imaging tests (X-ray, CT scan, MRI)
• Bone scan if required

“Early evaluation helps rule out serious causes and ensures timely treatment if needed. Back pain is rarely a sign of lung cancer in its early stages. But when it follows certain patterns, persistent, unexplained, and accompanied by other warning signs, it must not be dismissed as “just ageing” or “work strain.” Staying attentive, asking the right questions, and seeking timely care can make all the difference,” concludes Dr Sunny.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.