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Back pain: Cancer, stones and tumours

In the last couple of columns I have discussed causes of neck, arm and back pain. This month we are going to look at three rare causes of low back pain.Although not as common, prostate cancer, kidney ...


In the last couple of columns I have discussed causes of neck, arm and back pain. This month we are going to look at three rare causes of low back pain.

Although not as common, prostate cancer, kidney disorders (stones) and spinal tumours represent a small percentage of back pain. Since low back pain is a common condition, many people ignore it and do not realize that there may be a more serious underlying problem that is causing the pain. All three should be considered as a differential diagnosis in order to treat it properly and effectively. Luckily, the majority of back pain is benign and self limiting.

The good news is that most low back pain is due to mechanical causes (muscles, joints) that can be treated and resolved within weeks to months.

Prostate cancer is the most common cancer in men, excluding skin cancer. After lung cancer it is the leading cause of cancer death in Canada. One in eight men will be diagnosed with prostate cancer and about one third of them will die from it. Men over the age of 50 have an increased risk. The cause of prostate cancer is both hereditary and environmental. Diets low in selenium, high in red meat fat, and/or smoke, increase the risk of prostate cancer.

Although there are no symptoms of early prostate cancer, symptoms such as chronic low back pain (months), difficulty with urination (starting and stopping), a poor stream during urination, a burning sensation while urinating or excessive urination at night should not be ignored.

These symptoms are not specific to prostate cancer, but can also indicate other urinary problems. Early detection is very important in order to treat it successfully. Yearly physical examinations are necessary for all men over the age of 50. Along with the examination of the prostate, be sure that your physician also orders blood tests, to measure the levels of prostate specific antigen (PSA). PSA is a substance that is produced in the prostate. Once the prostate is enlarged, there are higher levels of PSA found in your blood. An increased level of PSA in your blood, is one of the earliest signs of prostate cancer.

If prostate cancer is detected early, it can be treated. Surgery and/or radiation therapy are the primary methods of care. A proper diet is critical in reducing the risk of prostate cancer. Vitamin D and E supplements along with a reduction in overall dietary fat will decrease the risk of prostatic cancer.

Another rare source of back pain comes from the kidney. There are many conditions that can affect the kidney, which can refer pain to the low back. Any type of inflammation/infection in the kidney or an obstruction in the ureter can cause low back pain. Since kidney stones are probably one of the most prevalent kidney conditions, special attention should be directed to it.

The kidneys are the body’s filtering system. The blood in your body passes through them and any unwanted substances are excreted in the urine. Unfortunately, if there is a build-up of certain chemicals or minerals, kidney stones are formed. There are many factors that play a role in the formation of these stones. Age, sex, a family history of kidney stones, the amount of water consumed, climate, and dietary factors are just a few things that contribute to their formation. Calcium oxalate (most common), calcium phosphate and uric acid are three different types of kidney stones.

The pain that is caused by kidney stones is due to an obstruction of the ureter, the organ which connects the kidney to the bladder. The bladder stores the urine until it’s time to get rid of it. Kidney stones are not always smooth and round; they can have jagged edges. As these kidney stones pass through the ureter they scrape the inside of it, causing severe pain. Symptoms include blood in urine, a burning sensation while urinating, difficulty urinating, nausea/vomiting and/or excruciating back, abdominal or groin pain.

If you are experiencing any of these symptoms, you may have kidney stones and it’s important to visit your doctor immediately.

Drinking a lot of water and keeping well hydrated is one of the best ways to decrease your risk of having kidney stones. The stones are usually small enough that you will pass them in due time. If the stones are too large to pass, shock wave lithotripsy and various types of surgical procedures are done.

Spinal tumours are probably the rarest of the three conditions that we are discussing. These tumours are uncommon but still represent a small percentage of causes of low back pain.

Spinal tumours can either be benign or malignant. Benign tumors of the spine grow slowly and are less aggressive. These tumours can become a problem when they get too large and compress or impinge the spinal cord or peripheral nerves. There are several benign tumors that originate in the spine, including hemangiomas, osteoblastomas and osteochondromas. Depending on the type of tumour and its characteristics it may be left alone or removed. Chemotherapy and radiation therapy may also be used.

– Dr. Jerry Singh, B. Kin., D.C., runs Trans Canada Chiropractic at 230 Truck Stop in Woodstock, Ont. He can be reached at 1 888 252-7327, or e-mail singhjerry@hotmail.com.


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