Advanced prostate cancer can sometimes cause chronic back pain. This usually happens in the later stages, when cancer spreads to the bones in the spine.

The prostate is a walnut-sized gland that sits below the bladder and wraps around the urethra. This gland is part of the male reproductive system and is involved in the production of semen.

In advanced prostate cancer, cancer cells spread beyond the prostate to other parts of the body. These cells usually spread to the bones first. Doctors refer to this as bone metastasis. If the spine is affected, a person may experience back pain.

This article looks at the link between back pain and prostate cancer. It also examines the options for pain relief.

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There can be a connection between back pain and prostate cancer, but back pain alone is not necessarily a sign of the disease.

Back pain is most likely to relate to prostate cancer in the later stages if cancer spreads to the bones. Metastatic prostate cancer most often reaches the spine, ribs, and hips. This usually occurs in stage 4 prostate cancer, and it can cause pain.

Bone metastases affect as many as 70% of males with prostate cancer. Individuals with chronic back pain that have no obvious cause should see a physician for an evaluation.

Learn more about bone metastases in prostate cancer.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Back pain caused by prostate cancer that has spread to the spine may have some of the following symptoms, depending on where the cancer is located:

  • pain increases with movement
  • pain is worse at night or when lying down
  • stiffness in the back or neck
  • difficulty walking
  • less sensitivity to pain, cold, and heat
  • numbness, weakness, or tingling in the legs or arms

The primary risk factor for developing back pain is if cancer progresses and metastasizes to the bones, particularly in the back.

In addition, one of the most significant risk factors for prostate cancer, in general, is aging, which can also contribute to back pain.

According to the American Cancer Society, this type of cancer is rare among males under 40. About 60% of cases happen in males over 65. The average age at diagnosis is around 66.

Another risk factor for prostate cancer is ethnicity, but researchers do not understand why. The ACS states prostate cancer is more common in African American males and Caribbean males with African ancestry. These males also tend to be younger when prostate cancer first develops.

The disease is less common in Asian Americans and Hispanic or Latino males than in non-Hispanic people who are white.

Having a family member with the disease may also increase a person’s chances of developing it.

Other risk factors for prostate cancer may include:

Anyone who has already received a prostate cancer diagnosis and begins to experience recurring back pain should see a doctor as soon as possible. Unexplained back pain can indicate that cancer has spread.

People with back pain who are concerned about the risk of prostate cancer should speak to their doctors.

Prostate cancer often causes no symptoms in the early stages. According to the National Cancer Institute, the most common method of detecting this cancer in the United States is prostate-specific antigen (PSA) screening.

Levels of this protein increase when the prostate is dealing with irritation, swelling, or the growth of cancerous cells.

The U.S. Preventive Services Task Force recommends that males ages 55–69 discuss the risks and benefits of prostate cancer screening with their doctors.

To determine whether a person’s back pain is related to prostate cancer, a doctor may order X-rays. These may reveal denser, more opaque bone tissue, called ivory vertebra, which most often occurs due to prostate cancer or breast cancer spreading to the spine.

A magnetic resonance imaging (MRI) or computerized axial tomography (CAT) scan will show any damage or disease affecting the discs, ligaments, and other soft tissues that may result from metastasized prostate cancer.

Doctors can also diagnose bone metastases using a bone scan. This involves injecting a small amount of radioactive dye into a vein. The technician then scans a person’s body with a special camera, and the dye helps reveal bone damage that may result from cancer.

AS UE person living with prostate cancer and experiencing back pain can take pain-relieving medications.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve) may help relieve mild back pain. For moderate to severe pain, a doctor may prescribe stronger pain medication.

Other common treatments for symptoms of back pain include:

In more extreme cases, a doctor may recommend:

However, the ultimate way to treat any type of cancer symptom is to treat cancer itself. For this reason, a person should consult with their doctor to find out if pain medications are safe to take in combination with cancer treatment.

There are various treatment options for people with prostate cancer. They include:

  • Prostatectomy: This involves removing the prostate and some of the surrounding tissue.
  • Radiation therapy: This consists of using targeted radiation beams to kill cancer cells in the spine and relieve pain.
  • Bisphosphonates: A doctor may intravenously inject drugs such as zoledronic acid (Zometa) to relieve pain and slow the growth of cancer cells.
  • Radiopharmaceuticals. If cancer has spread to multiple bones, a doctor can use these drugs to simultaneously target and kill cancer cells in all the affected bones.

Back pain, particularly in the short term, is a very common medical complaint. Possible causes can include:

However, if a person’s back ache is chronic, and they also have prostate cancer or are more at risk for developing it, it is a good idea to see a doctor as a precaution.

The following are the answers to some common questions about back pain and prostate cancer.

What are the other symptoms of prostate cancer?

Prostate cancer usually has no early warning signs. Because of this, many doctors and health authorities recommend screening males at risk.

When prostate cancer does cause symptoms, they may include:

However, these can also be symptoms of other conditions, including:

Neither of these conditions involves cancer, but it is still important to see a doctor for evaluation and treatment.

At what stage does prostate cancer cause pain?

There may be symptoms in the first three stages of prostate cancer.

As this cancer advances into stage 4, it spreads beyond the prostate to other organs in the body. It is now called metastatic prostate cancer and may cause pain in the areas of the body to which it has spread.

For example, metastatic prostate cancer that spreads to the spine may cause back pain. If it spreads to the brain, it may cause headaches.

What is the prevalence and outlook of prostate cancer?

According to the American Cancer Society (ACS), prostate cancer is the second most common type of cancer among American males, affecting 1 in 8 over the course of their lifetimes.

The outlook for people with prostate cancer is encouraging, particularly when doctors diagnose it early. The ACS reports a 5-year relative survival rate of 98% for all stages of prostate cancer.

Prostate cancer is common among males in the U.S. It usually progresses slowly and responds well to treatment. Most people who receive a diagnosis of prostate cancer do not die from it.

Back pain can sometimes occur with advanced prostate cancer. However, back pain on its own does not necessarily indicate that a person has the disease. This pain is a common medical complaint and has many possible causes.

Anyone experiencing back pain and who is at risk of prostate cancer should consider speaking to a doctor.