The most common symptom of a spinal tumor is back pain that is usually worse at night or upon waking.
However, most back pain is not caused by tumors and not all tumors are symptomatic.
Neurological symptoms, such as weakness, tingling or numbness in the arms or legs may also develop due to a spinal tumor, but these symptoms tend to occur several weeks or months following the onset of back pain.
Patients may experience one or any combination of the following symptoms, and some people with metastatic spinal tumors do not have any symptoms at all. It is important to document symptoms, as they can be used to help diagnose metastatic spinal tumors.
Metastatic Spinal Tumor Pain
The back pain that is caused by spinal tumors generally tends to be described as severe and not relieved by rest or pain medication.
There are a number of types of pain that can be caused by spinal tumor growth.
Aching pain in the bones
Tumor growth can result in a number of biological responses, such as local inflammation or stretching of the anatomical structures around the vertebrae. These biological sources of pain are often described by patients as a deep ache that tends to be worse at night, even to the point of causing one to wake up from the pain, and/or pain that is worse first thing in the morning after waking up and improves somewhat after getting up and moving around.
Pain that shoots down the arm or leg
This type of nerve pain, also called radicular pain, travels along the path of the nerve – down the leg if the tumor is in the lumbar spine, or down the arm if the tumor is in the cervical spine. Radicular pain is often described as burning or shooting pain that follows the path of the nerve into the extremities. Radicular pain may be accompanied by neurological symptoms along the affected nerve, such as weakness, tingling or numbness.
Pain with movement
If the tumor is growing within the vertebra, the walls of the vertebra can become thin and weaken. If left untreated, the bones can fracture. A vertebral fracture can result in sudden onset pain that tends to be more severe during movement or when placing pressure on the bone, such as when sitting and standing.
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After pain, the next most common symptom of metastatic spinal tumors is neurological dysfunction, such as tingling, weakness and/or numbness, or impaired muscle control in the arms or legs.
Neurological symptoms can occur if the tumor growth or vertebral fracture compresses neurological structures in and around the spine. In addition to nerve symptoms that accompany radiculopathy (as discussed above), potentially serious neurological symptoms may include:
- Loss of ability to control the bladder or bowel
- Instability while walking
- Diminished sensation, particularly below where the tumor is located
- Overactive reflexes, such as twitching and spastic tendencies
- Rapid succession of alternating contractions and partial relaxations
Cauda Equina Compression
Significant compression of the cauda equina (bundle of nerves at the base of the spine) may result in varying degrees of bowel or bladder problems, lower extremity weakness and/or loss of sensation in the buttocks. This condition requires immediate medical attention and may require prompt surgery.
Spinal Cord Compression
Compression of the spinal cord may result in various degrees of limb weakness and an impaired ability to move limbs. Other symptoms may include:
A correct and complete diagnosis of neurologic symptoms is necessary to determine appropriate treatment.