Can bone metastases cause spinal cord compression?

Malignant spinal cord compression is an emergency because pressure can damage nerves controlling movement, sensation, bladder and bowel function. Rapid assessment offers the best chance of preserving these functions.

Tumour growth within a vertebra can make the bone collapse, or soft tissue from a spinal metastasis can extend towards the cord. Back or neck pain is often the first warning and may be new, progressive, worse at night, increased by coughing or straining, or felt as a band around the chest or abdomen.

As pressure increases, a person may notice leg or arm weakness, heaviness, tingling, numbness, unsteady walking or altered sensation. Difficulty starting urination, loss of bladder or bowel control, and numbness around the buttocks, inner thighs or genitals are especially concerning neurological changes.

If you have cancer and develop possible spinal cord compression symptoms, contact the oncology emergency number immediately or go to an emergency department. Do not wait for a routine appointment, and do not drive yourself if weakness, numbness or poor coordination affects safe control of a vehicle.

Until assessed, limit unnecessary movement and avoid lifting or forceful exercise if the spine may be unstable. Clinicians may arrange an urgent neurological examination and spine imaging. Treatment can include steroids, radiotherapy, surgery, systemic cancer therapy, pain relief and support to stabilise the spine.

Seek emergency care now for new limb weakness, difficulty standing or walking, rapidly spreading numbness, loss of bladder or bowel control, inability to pass urine, or numbness in the saddle area around the buttocks and genitals.

New severe or rapidly worsening back or neck pain in someone with current or previous cancer also needs urgent contact with the cancer team, particularly when pain wakes the person, travels around the body, or is accompanied by tingling or altered balance.

Ask which spinal level is affected, whether the vertebrae are stable, what treatment must begin immediately, whether movement needs restriction, how pain will be controlled, and which rehabilitation or mobility support may be needed after pressure is relieved.