Back pain at rest CAN be caused by lung cancer.

But this comes with a “but.”

First off, do you have persistent back pain and are you a smoker?

It’s one thing to experience back pain whenever you stand up after sitting for a while, but then it quickly goes away once you’re up and about.

Or perhaps your back pain occurs only when you turn to the right side when seated.

But what about back pain that’s pretty much always there?

Can lung cancer ever be responsible?

“Yes…but,” says Alex Little, MD, a thoracic surgeon with a special interest in esophageal and lung cancer, and clinical professor at the University of Arizona.

“The only way a lung cancer can cause pain is by invading through the pleural lining of the lung and growing into the chest wall,” explains Dr. Little.

“This occurs — but is an infrequent occurrence. The most common example is the Pancoast tumor at the top of the lung that causes shoulder pain by invading the nerves in that area.

“I’m sure most back pain is due to etiologies other than lung cancer.

“Pain that persists over time despite standard treatment would be consistent with a lung cancer — but, again, lung cancer as a cause is unlikely.”

Though lung cancer as a cause of back pain at rest, even in a smoker, is not the most likely cause, there’s something else that must be considered.

Other cancers can cause back pain. The concerning issue is if the pain persists at rest, no matter how comfortable the patient tries to get.

What would be more reassuring is if chronic back pain can clearly be associated with certain activities or body positions, and goes away when those offending activities or motions are ceased.

Are you a smoker and have ongoing pain in the shoulder at rest?

“Persistent shoulder pain in a smoker is more worrisome and deserves evaluation with a chest X-ray and/or CT scan after common joint/muscle problems have been ruled out,” says Dr. Little.

“It brings to mind a popular medical aphorism: When you hear hoofbeats, think of horses, not zebras.”

Dr. Little trained in general and thoracic surgery at the Johns Hopkins University School of Medicine; has been active in national thoracic surgical societies as a speaker and participant, and served as president of the American College of Chest Physicians.