Is My Back Pain Cancer?
Should I See a Doctor or a Physiotherapist?
These are common questions our patients have regarding their back pain. It’s normal to worry and believe your back pain may be caused by something more serious. Especially when it doesn’t resolve the way you expect in 1-2 weeks.
Back pain is a common ailment, especially as we age. By the time you hit 50, it’s likely that you’ve had at least one episode of back pain, whether due to a muscle strain, poor posture, or simply the wear and tear of daily life. But what if your back pain is something more serious? Could it be cancer? And if you’re worried, should you see a doctor or a physiotherapist?
This blog will help guide you through understanding when back pain might be a sign of something more serious like cancer and when it’s appropriate to consult a doctor versus a physiotherapist.
Common Causes of Back Pain After 50
For most people aged 50 and above, back pain is typically due to non-cancerous causes, such as:
1. **Degenerative Disc Disease**: As we age, the discs in our spine can degenerate, leading to pain.
2. **Osteoarthritis**: Injury and sedentary lifestyle factors can affect the joints of the spine and cause arthritis, leading to stiffness and pain.
3. **Muscle Strains**: Overuse or improper lifting can strain muscles and cause pain.
4. **Spinal Stenosis**: This condition involves the narrowing of the spinal canal, which can put pressure on nerves and lead to pain.
These conditions are quite common and are generally manageable with conservative treatments like physiotherapy, exercise, and lifestyle modifications.
When Should You Worry About Cancer?
While back pain is usually benign, it’s essential to be aware of certain “red flags” that could indicate a more serious condition, such as cancer. Cancer-related back pain is rare but possible, especially in individuals with certain risk factors.
Key Red Flags for Cancer-Related Back Pain
1. **Unexplained Weight Loss**: If you’re losing weight without trying, and you have back pain, it could be a sign that something more serious is going on.The weight loss needs to be more significant than 1-2 lbs.
2. **Night Pain**: Back pain that wakes you up at night or is worse when you’re lying down might be a red flag. Cancer-related pain is often persistent and does not improve with rest or a change in position.
3. **History of Cancer**: If you’ve had cancer in the past, particularly cancers known to spread to the spine (like breast, prostate, lung, or kidney cancer), any new back pain should be evaluated by a doctor especially when you don’t have a clear mechanism of injury.
4. **Age**: While back pain is common with age, the risk of cancer also increases as we get older. New onset back pain in someone over 50 warrants a closer look, especially if accompanied by other red flags.
5. **Neurological Symptoms**: Numbness, tingling, weakness in the legs, or difficulty controlling bladder or bowel functions may indicate nerve involvement and needs urgent medical evaluation.
6. **Persistent Pain**: Back pain that does not improve with conservative treatments or continues to get worse over time should be assessed by a healthcare provider. If you haven’t seen a physiotherapist yet then it’s best to start here. Chronic back pain is not something you need to just “accept”.
Should You See a Doctor or a Physiotherapist for back pain?
If you’re experiencing back pain and wondering whether to see a doctor or a physiotherapist, here’s a guide:
When to See a Doctor for back pain?
You should see a doctor if you have any of the red flags mentioned above. A general practitioner (GP) or a specialist, such as an orthopedic doctor or an oncologist, can conduct a thorough assessment, which may include a physical examination, medical history, blood tests, or imaging studies like X-rays, MRIs, or CT scans.
Seeing a doctor is also crucial if:
– Your pain is severe and sudden especially after trauma
– You have a history of cancer.
– You experience unexplained symptoms like fever, chills, or night sweats.
– The pain is unresponsive to over-the-counter medications or conservative measures.
In these cases, a doctor can rule out or diagnose serious conditions like cancer and refer you to the appropriate specialist if needed.
When to See a Physiotherapist for Back Pain?
The vast majority of cases a physiotherapist is your first port of call for back pain. Namely because we are more experienced at seeing back pain and have more time to asses you. If required a physio can refer to a doctor or a consultant. If your back pain is mild to moderate and doesn’t present with any of the red flags, a physiotherapist is often an excellent first point of contact. Physiotherapists are skilled in assessing and treating musculoskeletal conditions, and they can help with:
– **Pain Relief**: Through manual therapy, exercise prescription, and modalities like ultrasound or TENS, physiotherapists can help reduce pain.
– **Improving Mobility and Independence**: Stretches and strengthening exercises tailored to your condition can help improve your range of motion and functionality.
– **Posture and Ergonomics**: Physiotherapists can provide guidance on improving your posture and setting up your work environment to reduce strain on your back.
– **Prevention**: They can teach you exercises and strategies to prevent future episodes of back pain, which is particularly important as we age.
If a physiotherapist identifies any concerning signs during the assessment, they will refer you to a doctor for further investigation. This collaborative approach ensures you receive comprehensive care tailored to your specific needs.
The Role of Imaging and Diagnostic Tests
If cancer is suspected, your doctor may order imaging tests. Common imaging studies include:
– **X-rays**: These can help detect bone abnormalities, such as fractures or tumors.
– **MRI**: This imaging provides detailed images of soft tissues, including muscles, discs, and nerves, and is often the test of choice if there’s a suspicion of cancer.
– **CT Scans**: These provide cross-sectional images of the body and can help identify abnormalities in bones and soft tissues.
These diagnostic tools help in confirming or ruling out serious conditions, including cancer, and in determining the appropriate course of treatment. Less than 10% of cases need imaging for various reasons so the likelyhood of you needing and X-ray or MRI is very low.
Please read my blog on “When to get an X-Ray or MRI?” here.
Conclusion: Stay Vigilant but Calm
While it’s essential to be aware of the potential for back pain to signal something more serious like cancer, it’s also crucial not to panic. The vast majority of back pain cases, especially in people aged 50 and above, are due to non-cancerous conditions that respond well to conservative treatments like physiotherapy. Back pain can be complex and needs a personalised approach. This way we can take your injury history, medical history and lifestyle into consideration for your treatment and rehabilitation plan.
The key is to be vigilant about your symptoms. If you notice any red flags or if your back pain is persistent and unresponsive to treatment, don’t hesitate to consult a doctor. For most cases of back pain, seeing a physiotherapist is the best first step. They can provide effective treatment and will refer you to a doctor if they detect any signs that need further investigation.
By taking a proactive approach and working with healthcare professionals, you can manage your back pain effectively and maintain a good quality of life as you age.
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