Physical Therapist Reports Back Pain From Cancer
Physical therapists (PTs) report a case of low back, hip, and leg pain from cancer. In today's health care system patients can see a PT without seeing a doctor first. This is called direct access. Therapists must know how to recognize signs and symptoms of illness or disease affecting the spine.

The patient was a 45-year old man who had never been seen by a doctor or other health care provider for this problem. There were no medical records on file.

There were some findings on exam to suggest a true back problem. However, the therapist was tipped off to a serious medical condition by the following:

  • Most intense pain at night
  • No known cause of pain
  • Unusual loss of left hip motion
  • Patient did not improve with physical therapy

    The PT advised the patient to see a medical doctor. Special tests showed lung cancer with metastases to the spine.

    The authors point out that cases like this are rare but show how PTs must know what to look for as signs of serious disease causing back pain.
    Michael D. Ross, PT, DHS, OCS, and Edmond Bayer, MPT. Cancer As a Cause of Low Back Pain in a Patient Seen in a Direct Access Physical Therapy Setting. In Journal of Orthopaedic & Sports Physical Therapy. Vol. 35. No. 10. Pp. 651-658.