Does Colon Cancer Cause Back Pain?

Medically reviewed by: Eiman Firoozmand, MD

While colorectal cancer has a characteristic set of symptoms, it can also be an unusual cause of back pain in some cases. Back pain on its own might be a small concern for most patients, but back pain in colon cancer patients should not be ignored.

So in this post, let us dive deep into why colon cancer can cause back pain, what it feels like, other common causes of back pain, and how to treat back pain due to colon cancer.

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Can colon cancer lead to back pain?

Yes, bowel cancer can rarely lead to back pain. When other causes of back pain have been ruled out, there are only a handful of explanations for it in colorectal cancer patients. Either the cancer has spread to the spine, is blocking the bowel, or the pain is a side-effect of colon cancer treatment.  

Let’s take a look at these mechanisms in more detail:

  • Metastasis (colon cancer spread): Colon cancer initially arises in the gut. When it becomes advanced, it begins to spread beyond the gut to involve various organs in the body. The most common site of spread is the liver but the cancer can sometimes also spread to the spine, causing back pain.
  • Bowel obstruction: Sometimes, pain from an organ is felt away from its location. This is called referred pain and occurs due to common pain nerves that supply multiple areas in the body. So, referred pain from the gut may sometimes be felt in the lower back. 
  • Treatment side-effect: Colon cancer is treated using chemotherapeutic drugs such as capecitabine and oxaliplatin. One side-effect of these drugs is bone and joint pain, which can manifest as back pain.  

What does back pain from colon cancer feel like?

Back pain caused by advanced bowel cancer has characteristic features that might clue a person in. These include:

  • Constant: The first feature is constant pain. Because colon cancer invades tissues in the back, it sits there and does not go away. So, the pain persists as long as the cancer is there. 
  • More at night/early morning: Colon cancer-related back pain is often much more severe at night or early morning. 
  • Associated with numbness or tingling: In some cases, people with colon cancer might experience numbness or tingling in their limbs. This happens when the cancer compresses the spinal cord or the nerves in the back. 
  • Radiation to other regions: Colon cancer pain can radiate to the abdomen, hips, and legs. 
  • Lower back: While back pain due to colon cancer can occur anywhere along the length of the spine, it most commonly affects the lower back. 
  • Does not increase with exercise: Back pain that increases with exercise points towards an issue with the blood supply of the back. In back pain due to colon cancer, there are no issues with the blood supply so the pain may not increase with exercise.

What are other common causes of back pain?

Other common causes of back pain include muscle strain, arthritis, and osteoporosis. These conditions are far more common than colon cancer, so your doctor will always rule them out first if you go to them with back pain. Here is a deeper look:

  • Muscle strain: The most common cause of back pain is muscle or ligament strain. Sudden stretching of a muscle or repetitive muscle strain in an untrained individual can cause spasms in the muscles of the back. This shows up as back pain. 
  • Arthritis: Arthritis, or inflammation of the joints, is another common cause of back pain. Arthritis due to mechanical wear and tear of the joints is called osteoarthritis and is common in the elderly. There are other forms of arthritis as well, such as rheumatoid arthritis. All forms can affect the spine and cause back pain. 
  • Osteoporosis: Osteoporosis is a disease in which bones become weak and fracture easily. It classically affects old males and post-menopausal women.
  • Bulging discs: Between the bones that make up the spine are discs that act as cushions against friction and shock. Sometimes, a disc will move out of its natural location and bulge into the spinal canal. This causes it to press on the spinal cord or nerves, causing severe back pain.

How is colon cancer back pain treated? 

Colon cancer back pain is treated based on what’s causing it. Let’s take a look. 

  • Chemotherapy: If the back pain is due to cancer spread, your doctor will prescribe chemotherapeutic drugs that specifically target colon cancer — both in the gut and the back. 
  • Radiotherapy: Like chemotherapy, your doctor might recommend radiotherapy if your back pain is due to direct cancer spread. Preoperative chemotherapy and radiotherapy is often used to treat rectal cancer symptoms and shrink it before an operation.
  • Analgesics: Cancer pain is also treated using pain medications, especially opioids, which are the strongest painkillers currently available.
  • Applying cold/heat: Using cold or heat packs also helps provide symptomatic relief against colon cancer back pain. It’s a good option for those waiting for more definitive treatment.

What are other signs and symptoms of colon cancer to look out for? 

Other signs of colon cancer include blood in stools, weight loss, abdominal pain and diarrhea or constipation. Back pain alone is unlikely to be colon cancer. But when combined with one of these signs, it can point toward colon cancer and should be taken seriously. Here is a more detailed description of other colon cancer signs:

  • Blood in the stool: Blood in the stool, which may or may not be visible to the naked eye, is usually the first symptom of colon cancer. However, there are many causes of blood in the stool, such as hemorrhoids, inflammatory bowel disease, and anal fissures. So, it is not diagnostic of colon cancer. Instead, it highlights the need for additional testing. 
  • Weight loss: Sudden weight loss (over weeks or a few months) is a symptom of cancer in general. 
  • Abdominal pain: Because colon cancer grows in the gut, abdominal pain is another common symptom of advanced colon cancer. 
  • Diarrhea: Diarrhea can be a symptom of colon cancer. It occurs when the tumor secretes extra fluid into the gut and the healthy gut is unable to reabsorb it.
  • Constipation: Colon cancer can obstruct the lumen of the gut or wrap around the bowel to make it narrow. In both scenarios, the stool that passes through the bowel has to squeeze through the narrowed space. This makes it difficult to pass stool.
  • Altered stool shape: Colon cancer makes the lumen of the gut narrow. This can change the shape of the stool and make it narrower in addition to leading to altered bowel habits.
  • Weakness/fatigue: Any long-standing disease can cause fatigue and colon cancer is no different.

It is important to note that some people are more likely to develop colon cancer than others. These include those with a family history of colon cancer, Lynch syndrome patients, and patients who suffer from inflammatory bowel disease. And so, colon cancer symptoms in such individuals should definitely prompt a visit to the doctor. 

What other cancers can cause back pain?

There are many other cancers that cause back pain, such as spinal cancer that originates from the bone. Here are a few examples:

  • Multiple myeloma: Multiple myeloma is a type of bone marrow cancer. And it leads to increased breakdown of bone all over the body. This also involves the back and can cause small fractures, which cause back pain. 
  • Osteosarcoma: Osteosarcoma is a cancer of the bone itself. When it originates in the spine, it causes inflammation of the bone leading to back pain.
  • Chondrosarcoma: Chondrosarcoma originates from cartilage-producing cells. It can originate in the cartilage of the spine and lead to back pain.
  • Spread from other cancers: Technically, any cancer can spread to the back. However, some cancers show a greater tendency to metastasize to the back, such as lung cancer, breast cancer, and prostate cancer. 

Frequently Asked Questions about colon cancer and back pain

What side of your back hurts with colon cancer? 

Back pain due to colon cancer can occur anywhere along its length. However, it usually affects the lower back. 

What is the biggest symptom of colon cancer? 

The biggest symptom of colon cancer is blood in the stool. This is why most colon cancer screening tests look for blood in the stool to detect it. However, depending on the cancer site, some people may experience only a change in bowel habits.

Does colon cancer spread to the back often? 

No, colon cancer does not spread to the back often. Only when cancer reaches an advanced stage does it metastasize to the back. In fact, there are other cancers like lung and breast cancer that are more likely to spread to the back than colon cancer. 

What are the signs that colon cancer has spread? 

Colon cancer spread will usually show up on imaging tests, such as a CT scan or a PET scan. However, a doctor might be able to tell that the cancer has spread by taking a good medical history and observing signs in other organ systems, such as a new cough with blood in a known case of colon cancer.

What part of your body hurts when you have colon cancer? 

Colon cancer will most commonly cause abdominal pain. Back pain is rare in colon cancer but it might occur.

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