What should you know about impending spinal cord compression?

Cancer can weaken a vertebra or form a mass beside the spine. Pressure may disturb the spinal cord or nerve roots, affecting movement, sensation, and bladder or bowel control. The back pain may be severe, worsen when lying down or coughing, or feel like a band around the chest or abdomen.

Doctors may use neurological examination and urgent imaging to locate the pressure and assess stability. Causes can include cancers that spread to bone; multiple myeloma is one condition associated with bone problems, but many cancer types and non-cancer causes can affect the spine.

Treat new or changing symptoms as urgent: contact your oncology team or emergency service immediately and say that spinal cord compression is a concern. Avoid delaying assessment to see whether symptoms settle. Keep a list of medicines and describe exactly when pain, weakness, numbness, or bladder changes began.

Treatment may include medicine to reduce swelling, careful positioning, radiotherapy, or surgery. The choice depends on the site of pressure, spine stability, overall health, and the cancer involved. Palliative radiotherapy can be used to relieve symptoms when appropriate, while surgery may be considered for selected forms of compression.

Go to emergency care now for new leg weakness, difficulty walking, numbness that is spreading, loss of bladder or bowel control, or inability to pass urine. Severe new back pain in someone with cancer also warrants immediate advice, even without weakness.

Which scan is needed and how quickly? Is my spine stable, and should I limit movement? What treatment will protect nerve function? Who should I contact overnight if pain, weakness, sensation, or bladder and bowel symptoms change?