Is Your Upper Back Pain a Sign of Cancer?

Upper back pain can happen for all kinds of reasons. Maybe you tweaked something when you were working in the yard. Or maybe it’s time for a new pillow.

But you may worry it could mean something much more serious: Could your upper back pain be a sign of cancer?

Medical oncologist Dale Shepard, MD, PhD, says the concern is understandable. But most of the time, cancer isn’t to blame. “In people who don’t have a history of cancer, I wouldn’t be worried about upper back pain by itself being a symptom of cancer.”

Still, there are times when your back pain deserves more attention. Dr. Shepard explains what you need to know.

Can upper back pain be a symptom of cancer?

There are cases when cancer could potentially cause upper back pain. But the pain alone isn’t usually enough to lead doctors to worry about cancer.

“Back pain itself doesn’t throw up a red flag necessarily,” Dr. Shepard clarifies. “It’s the context that tells us more.”

That’s because most upper back pain stems from your musculoskeletal system — meaning it comes from troubles in your muscles, joints, tendons and the way you move day-to-day. In other words, not cancer.

Warning signs that suggest cancer

Most people with upper back pain don’t have cancer. But certain symptoms merit a talk with a healthcare provider.

Cancer warning signs include:

• Unusual fatigue: A certain amount of tiredness may be normal for you. But feeling exhausted despite sleeping more, needing frequent naps when you never used to or feeling drained with minimal activity can be a red flag.
• Unexplained weight loss: “We normally think of unusual weight loss as losing about 10% of one’s body weight without trying,” Dr. Shepard says. Even if weight loss seems welcome, it’s important to understand why it’s happening.
• Unusual lumps and bumps: New or changing lumps — especially ones that don’t go away — should always be checked. While many lumps are harmless, they’re something a healthcare provider should evaluate.
• Pain that keeps getting worse: Muscle-related pain often improves with rest or time. Pain that steadily worsens, instead of getting better, may signal something beyond a simple strain.
• New pains in other areas of your body: Pain showing up in multiple places without a clear reason can be another clue that something else may be going on, especially if it’s persistent.
• Symptoms that don’t make sense or don’t improve: Dr. Shepard says people often try to explain symptoms away. But if something doesn’t add up or just feels “off,” it’s worth paying attention to your intuition.

“If something doesn’t seem right, have it checked,” he advises. Even if it isn’t cancer, it could be another health condition that’s easily treated.

Cancers that can cause upper back pain

Upper back pain is sometimes a result of cancer spreading (metastasizing) to the bones, including your spine. That can cause back pain that tends to stick around and isn’t linked to an obvious injury or strain.

“Certain cancers are known to spread to bones,” Dr. Shepard notes. “So, in people who have a history of cancer, back pain becomes something you take more seriously.”

Pay particular attention to upper back pain (and other pains) if you’ve been diagnosed with:

• Lung cancer
• Prostate cancer
• Breast cancer
• Multiple myeloma

But if you’ve had cancer of any kind, it’s important to stay vigilant for new symptoms.

“Cancers don’t read textbooks. They don’t always know where they’re ‘supposed’ to go,” he continues. “If you’re experiencing a new symptom and you have a history of cancer, you should get it looked at.”

Other causes of upper back pain

If you don’t have a history of cancer or any red-flag cancer symptoms, your provider will likely look for other causes for your upper back pain. Among the common ones:

• Muscle strain: Lifting something heavy, reaching awkwardly or doing repetitive movements can strain the muscles in your upper back. Even everyday activities, like painting, shoveling snow or carrying a heavy bag on one shoulder, can trigger pain.
• Poor posture: Slouching at a desk, staring down at your phone or leaning forward at a computer can put extra stress on your upper back and shoulders. Over time, that strain can lead to stiffness and soreness.
• Improper sleeping position: Using a pillow that doesn’t support your neck or sleeping curled up, twisted on your side or on your stomach can strain your upper back muscles overnight, leading to pain when you wake up.
• Stress: Tension often shows up physically, especially in your neck, shoulders and upper back. When you’re stressed, those muscles can tighten and stay tight, causing ongoing discomfort.
• Age-related changes: As you get older, normal wear and tear on your spine and joints can cause stiffness and pain in your upper back.

When to see a doctor

Make an appointment for upper back pain if:

• It lasts more than a few weeks.
• It keeps you from going about your daily activities.
• You have any other new or unusual symptoms.
• You have a history of cancer.

Even when it’s not serious, getting your upper back pain checked out can still help.

“Sometimes, it’s just a matter of being evaluated, making sure everything’s fine,” Dr. Shepard reassures. “Then, maybe something like physical therapy can help, but you want to make sure you don’t miss a symptom of something more serious.”