I'm confident many individuals, upon receiving a PCa diagnosis, begin to fear that any back or hip discomfort might signal the cancer spreading to the spine or elsewhere.
Is it possible, without having frequent expensive scans, to distinguish between bone pain related to PCa and general back pain? For instance, does PCa affecting the spine or hip generate a pain that feels distinctly different from a strained back or a pulled muscle in that area?
Would discomfort from a misaligned back that's only felt during stretching or twisting, differ from pain caused by a bone tumor? Some suggest that PCa bone tumors produce a persistent, dull ache irrespective of body position.
It would be beneficial if we could somewhat determine whether our typical aging bone aches and pains are related to PCa metastasis or not.
Thoughts?
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Mike58
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I am in the gym 5 days a week. I can tell the difference because pain is every day and consistent. I experienced pain in my pelvis where there is really not anything to strain. The feeling is quite different than muscle pain
Thanks for your reply. I guess everyone is different and so each of our journeys are also different but it is still good to listen to the experiences of others. Thanks again.
Coincidentally Mike I had severe hip pain about a month ago and fortunately it's all gone now 😂. But I also went through a period of anxiety that it might be bone mets. Here is the link to a long discussion on the Forum just recently:
Thanks John, That link certainly provides everything there is to know about my question. I appreciate you sharing it. I hope you are keeping that PCa at bay and will do so for another 20+years!!! All the very best.
A lot of people say this. Not easy in a real life situation. If you have an impending facture or an active lesion it seems possible that movements could trigger pain. Confusing pain. Maybe I'm wrong.
I speak from a little experience. I had a colonoscopy a year ago and afterwards I had severe pains. I wasn't certain if they were in my bones but stretching made them much worse. Never had pain after a colonoscopy before. So I didn't put 2 and 2 together.
I talked to my MO later that week and as soon as I told her that the pain got worse when I stretched she smiled and said that since stretching affected the pain there was no way they were mets.
She then told me that pretty much every guy with PCa thinks any kind of bone or muscle or tendon pain might be mets. Sensible advice is to talk to your MO about your specifics but don't lose sleep over it in the meantime.
Thanks mate. Yep I’m not losing sleep over it but it is only natural to try and put 2 + 2 together but often we come up with 5 and it ends up being nothing. But great to get everyone’s valued thoughts. 👍
Thanks for your reply. I'm thinking the same as you and hoping that to be the case. Johns link to this question is all encompassing and provides a lot more insight into this question.
This series of related questions on one topic, in this case distinguishing between muscle and tissue related pain on one hand and metastasis related pain on the other, highlights one of the challenges of using this wonderful site.
I have mentioned previously that somehow knowledge and experience collected on this site gets lost - and the site becomes just sort of where one skims the tips of the waves and mostly just the waves that have arrived in the last few days.
But substantial dialogues and valuable dialogues on one topic kind of disappear. It seems that Health Unlocked was designed a long time ago and needs investment to update the technology.
(By the way I'm familiar with another important cancer website that seems to have spent a lot of money on updating. And the result is to make user engagement more difficult! There are reasons for this but we just hope that in any eventual redevelopment of HU - I'm working on living a long enough to see that - avoids the many tempting pitfalls promoted by UX amateurs, gimmick-oriented programmers or obsessed marketers. In the meantime this site is still the best for prostate cancer that I have seen and it's not surprising that people from around the world visit!)
Good points all around. All sites I've been on have some repetition, but repetition often brings new viewpoints, additional nuanced answers. Taking answers on whatever topic and the applying it to our personal situation is often the challenge.
Sorry for the pain. I've had back pain for years now (definitely not related to slip on stairs due to jelly shots on Superbowl.) I also seem to have a constant pain in my ass. I don't think it's cancer. Probably j-o-h-n.
I have googled and there doesn't seem to be a remedy. I've tried all of the possible creams. I have admitted defeat and just increased my daily intake of Jack Daniels.
don’t get me wrong I only drink half the day.😍 also live on a fasting diet. in numerable and countless bone mets. Prognosis was one and a half to 2 1/2 years. Will be seven years next March. Or it could be the million dollars worth of Xtandi I have consumed.
My MO said if I have pain that lasts a week in the same spot to let him know. So far I haven't had any pain lasting a week so hoping that's good but it does set my mind at ease. I get scans in January. I do know from this forum that we do not all experience pain the same way either though I suspect when bone pain is present it is similar.
Oh dear. I’d be getting scans every week or so if I reported a back ache that lasted more than a week. But hey your MO is probably erring on the side of caution and I get that.
It can be difficult to distinguish between pain caused by mets and by other causes. It is very easy to get hypersensitive (as I have) to the cancer thing, thinking that every time something goes wrong it is the big C!
I just had a number of scans that show exactly where my pc is and together with my accelerating PSA and history confirm that the pain in my shoulder is at least in part caused by the cancer.
Cancer causes pain in bones is a few ways. Inflammation is an indirect cause of pain. By alternating the pain meds you are taking you might get a better guess as to the cause of the pain. For me the pain varies so much and I have been less than consistent on keeping track of symptoms or medications that I can not honestly make specific recommendations but here goes:
My pain was shown to be at a high uptake area of PSMA ligand. Stopping NSAIDS brought the pain back sooner at met sites than it did the pain not at mets. Increasing morphine fixed it all at least temporarily. No idea what is happening with inflammation but pain is under control. Will see what meds are needed tonight since I can now choose After that I might have a fairly decent idea as to how to distinguish met bone pain from other pain.
Wow. You have thrown everything at your PCa. Well done! Thanks for your reply. I really hope you continue to make good mileage in your ongoing experience of life. 👍
Interesting post. Ive had really bad lower back pain for a few years, now worse than ever. Ive been taking oxy but I hate it and its really up and down relief. They are now moving me to a trans-dermal, Butrans. Its a dull ache that gets worse the longer Im on my feet but now in just an hour or two. Ruining my already embattled life.
Since I've had a cannabis prescription I find that some days an aspirin and some high CBD cannabis do the trick for my pain (sometimes naproxen and cannabis when I need to step up), I hate the morphine as it makes my nausea worse (the cannabis also fixes the nausea but I can't really cope with both without passing out)
As one of my oncologists says "Cancer is the pain that doesn't go away". I have a lot of back pain, getting worse all the time, but no metastases in my back. The metastases were in my ribs which have not been painful yet.
Steve: Apparently you are only on ADT? Yet you have metastases? Your note was a trigger for me because my high volume surprise metastatic prostate cancer started with a dull backache and then the ribs were added. Almost 2 years later I'm doing well now with a PSA of zero and benefiting from triplet therapy. If you are truly metastatic PCa then only being on ADT would seem to be a big concern, especially in Texas where you all have advanced therapies.
I think it depends, in part, on where in the hips the lesions/metastises are. In my case, they are in the hip socket, so yes, there is a lot more pain associated with movement sometimes, but, interestingly, not always. Sometimes it keeps me awake no matter what drugs I take, and it is impossible to find a comfortable position. Other times, no pain at all in the night. My $0.02
My experience is only with a femur lesion. However, back, neck and joint pain can be from a compressed disk, sleeping in a weird position or lifting heavy items. The key from my experience is the unrelenting pain.
Pain that disappates or is intermittent is typically not bone mets. However, mention symptoms to your MO and have it in you medical record for furture reference. Another interesting point that I both read about and then experienced was that when you have bone mets and go to a very high elevation, the pain gets exponentially worse. I had pain in my leg and then my wife and I went for a weekend at a ski resort, went to 11,000 elevation to the mountain top and I could barely walk! It was excrutiating pain.
So, consider all the causes and how it presents before freaking out. Lol. Good luck!
Thanks mate. Appreciate your reply. Not much chance of getting high elevation in Australia. The highest peak is only 7,200 feet.
Yeah I’m thinking my issue might be more muscle than bone pain. I was starting to do heavy weights on a machine in readiness for HT and I think maybe I did some damage. But now with having PCa you tend to link it to everything that now happens in our bodies.
I was all clear of Mets in early Sept so not sure things can happen that quick.
Anyway all the best with your treatments and I’m glad you can get away on holidays without too much hassle. I’m hoping to go overseas for 2 months while on HT. Should be interesting
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After that I might have a fairly decent idea as to how to distinguish met bone pain from other pain. 
Symptoms of beginning met to bones
Advice on pain meds for bone mets
Chemo not working for bone mets
Increase in bone Mets?
Bone Mets and rising PSA
