Prostate cancer and back pain: what every man over 50 needs to know
Sudden difficulty controlling your bladder or bowel • Numbness between your legs or in the saddle area • Rapidly worsening weakness in one or both legs • Sudden severe back pain after a fall in a man with known prostate cancer. These may indicate spinal cord compression — a medical emergency. Delay can result in permanent paralysis.
Constant back pain present at rest and at night • Night pain that regularly wakes you • Unexplained weight loss • Urinary symptoms: poor stream, blood in urine or semen, frequent night urination • Back pain not improving after 4–6 weeks • New back pain with no clear mechanical cause in a man over 50 • Any new back pain in a man with known prostate cancer.
Why prostate cancer and back pain are connected
Prostate cancer is the most common cancer in UK men. The spine is its most frequent site of spread, making it a critical consideration when a man over 50 presents with back pain that does not have a clear mechanical explanation. Most back pain in men over 50 is still mechanical — but the minority that is not is more significant than in younger men, and failing to identify it promptly has serious consequences.
PSA testing
PSA (prostate-specific antigen) is a blood test that can indicate prostate cancer when elevated. Any man over 50 with unexplained back pain should discuss PSA testing with his GP. The test is not perfect — it can be elevated for benign reasons and can be normal in some prostate cancers — but it is a simple, low-risk first step in investigation.
The back pain pattern of prostate cancer metastases
- Constant back pain present at rest and at night — not relieved by any position
- Pain that is progressive rather than episodic
- Associated systemic symptoms: fatigue, weight loss, general decline
- Urinary symptoms alongside back pain — poor stream, nocturia, haematuria
- History of prostate cancer, or elevated PSA on previous testing
Man over 50 with back pain that hasn’t been fully assessed?
The myBackPain assessment screens for the features that suggest cancer needs to be considered — and guides you toward the right investigation pathway.