A Common Cancer Pain Syndrome-Back Pain

In addition to the back pain caused by tumors in pancreas and other parts, spinal metastasis is one of the common causes of back pain caused by tumors, and malignant tumors in lung and prostate are the most likely to cause spinal metastasis. The compression of spinal cord and cauda equina by tumor spreading to epidural space is the second most common cause of back pain caused by tumor. At this time, the patient's condition is more urgent and should be treated in time. 90% patients with spinal cord compression have tender points in their backs.

Spinal cord compression can sometimes be the initial manifestation of malignant tumors. Most patients with spinal cord compression will have back pain. Because back pain is a common symptom in the general population, efforts should be made to find out the characteristic symptoms and signs related to tumors and tumors that are easy to metastasize to the spine, so as to distinguish them from some common benign chronic low back pain.

The characteristic symptoms of spinal cord compression pain in tumor patients are:

① Back pain that progresses rapidly and gradually increases;

② Unilateral or bilateral radicular pain;

③ Back pain or nerve root pain aggravated by sneezing, coughing or other sudden movements;

④ The supine position is aggravated, and the pain in standing or sitting position is relieved;

⑤ Lumbago still exists at rest, even affecting sleep;

⑥ Patients with straight spine and bent neck feel like an electric shock.

With the progress of spinal cord compression, patients will also have symptoms such as weakness of lower limbs, difficulty in going upstairs, progressive sensory loss below the level of injured spinal cord segment, and autonomic nerve insufficiency. These symptoms are very mild at first and are easily ignored by patients. Intestinal and bladder dysfunction can also occur in the late stage of spinal cord compression. Common signs are:

(1) Bone tenderness-usually at the spinal level, where neurological symptoms are consistent;

② joint proprioception disappears-epidural diffusion has involved the posterior column of spinal cord;

(3) Sensory changes-if the compression is carried out, the pain will change in the early stage, and the temperature perception may change earlier, and the saddle area will be numb when the cauda equina is compressed;

(4) Exercise weakness, rigidity or weakness-related to the progress period and speed of the disease;

Because the sequelae of nervous system injury are not easy to recover, effective treatment should be carried out before these sequelae appear, otherwise the patient will be paralyzed for life and incontinence.