Rarely, spinal infections or cancerous conditions cause lower back pain. Although all back pain should be evaluated by a qualified health professional, if the pain never goes away entirely, especially at night, attention is needed.
Cancer pain may be described as a constant toothache-like, ‘hard’ or deep, aching pain that never goes away; often not better lying down which makes this different than low back pain due to more common arthritic conditions. In general, pain starts slowly and progresses gradually with time. Warning signs for spinal cancer include unexplained weight loss, fevers or night sweats. Similar pain may be present in other bones as well, because most spinal cancers come from other locations, and have spread to the spine. Other common areas for cancer to spread to are the hips and thighs, ribs, shoulder area and pelvic bones. Previous cancers, especially lung, breast, prostate, thyroid, bladder, melanoma and kidney cancer (even if they had been treated) would be very important information for a health care provider.
Usually bone cancers which have spread are seen in older people. Bone cancers which start in the bones may be seen in children and young adults.
Infections in and around the spine cause pain. This is also a constant, day-and-night pain and may be due to bacterial or fungal infections in the vertebrae, the discs or the surrounding soft tissues and abscesses near the spinal canal. Infections may be more common in people whose immune system has become weakened, or recent surgery of the spine.
X-rays, MRI and CT scans help to identify the location of the tumor or infection. Usually a sample (biopsy) of the area is necessary for proper treatment, especially for infections.
Long term antibiotics frequently are necessary for spinal infections, and occasionally surgery is needed to remove infected tissue, or to drain abscesses. Treatment for spinal tumors depends on the type of cancer, but usually some form of relief is obtained with medication, surgery or radiation therapy.