Back Pain

doi:10.1017/9781009500760.002

Chapter 2 - Back Pain

Published online by Cambridge University Press: 24 April 2026

Angela Lindsay

Edited by

Angela Bray Lindsay and

Monica Kathleen Wattana

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Angela Bray Lindsay: Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana: Affiliation:
University of Texas, MD Anderson Cancer Center

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Summary

1. It is important to have a high index of suspicion for malignant spinal cord compression (MSCC) in patients who have a history of cancer and present with back pain. In the absence of neurologic symptoms or deficit, close follow up and outpatient imaging is indicated.

2. Pain is the most common symptom of MSCC and is present in 95% of cases.

3. Red flags of MSCC include extremity weakness, difficulty walking, loss of sensation, bowel or bladder dysfunction, thoracic or cervical pain, pain increased with straining, and pain that is worse at night.

4. MRI of the entire spine is indicated for accurate diagnosis and treatment of MSCC.

5. Treatment includes Dexamethasone IV bolus followed by maintenance dosing and radiation therapy with or without surgical decompression.

Keywords

Malignant Spinal Cord Compression Oncologic Emergency Spinal Metastasis Bony Metastasis Back Pain in Cancer Dexamethasone

Information

Type: Chapter
Information: Oncologic Emergency Medicine
Clinical Cases Illustrating Key Concepts
, pp. 5 - 8
DOI: https://doi.org/10.1017/9781009500760.002 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2026

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