Pain in the middle back can be more worrisome than the lower area, since this isn’t the most common area of back pain.

Cancer as a cause of mid back pain certainly impedes upon the minds of people who suffer from cancer anxiety.

“A variety of disorders can contribute damage of intervertebral disks, vertebrae, ligaments, neural structures, muscles and fascia leading to middle back pain,” says Ioannis Psallidas, MD, PhD, Honorary Consultant Respiratory Physician, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, who has a focus in thoracic oncology.

“Although most patients with middle back pain have a benign condition, serious, destructive diseases (for example cancer) are uncommon causes of back pain,” continues Dr. Psallidas.

“Back pain is the presenting symptom in 90% of patients with spinal tumors, and the spine is also one of the most common sites of metastasis: About 20,000 cases arise each year1.

“In a study published by Brihaye and colleagues, 1,477 cases of spinal metastases were reviewed and found that 16.5% arose from primary tumors in the breast, 15.6% from the lung, 9.2% from the prostate and 6.5% from the kidney2.”

In addition, ovarian cancer has the potential to cause pain in the middle back.

The take-home message is that if you begin having back pain, you should not lose sleep over the worry that it could be cancer.

The No. 1 cause of back pain is a combination of poor biomechanics and insufficiently trained muscles.

Shutterstock/Thaninee Chuensomchit

In other words, an average person incorrectly lifting a heavy box off the floor. This is a setup for a back strain or injury, which may not be felt right away.

Back Pain from Cancer

“Rarely, it may be the first manifestation of cancer,” says a paper in the Journal of General Internal Medicine (Deyo et al, May 1988).

The study authors point out that out of 1,975 walk-in patients at a clinic, only 13 were found to have cancer as a cause of their back pain.

Certain findings correlate to this, but these findings certainly don’t automatically mean cancer:

• At least 50 years of age

• Previous history of cancer

• Pain lasting longer than a month

• No improvement with conservative therapy

What’s scary is that the paper says that metastatic cancer, when causing back pain, may not always cause other symptoms.

When cancer causes back pain, it’s more frequently in the lower region. Thus, pain specifically in the middle back, from this disease, would be even rarer.

Quite simply, pain in the back, be it low, middle or upper, has MANY causes including inflammatory bowel disease, irritable bowel syndrome, gastroesophageal reflux disease (GERD), fibromyalgia, aortic disease, imminent heart attack, premenstrual syndrome, benign ovarian cysts and overdoing it in a yoga class.

Dr. Psallidas is the main author of many peer-reviewed publications and book chapters in pleural disease and lung cancer. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
Top image: shayne_ch13
-Gilbert RW, Kim JH, Posner JB. Epidural spinal cord compression from metastatic tumor: diagnosis and treatment. Ann Neurol 1978; 3:40–51.
-Brihaye J, Ectors P, Lemort M, Van Houtte P. The management of spinal epidural metastases. Adv -Tech Stand Neurosurg 1988; 16:121–176.
Can middle back pain be caused by cancer?