Metastatic spinal cord compression (MSCC) is a medical emergency which can result in paralysis. Many patients living with cancer have pain; within primary care it can difficult to differentiate between significant pain which may be due to MSCC, and pain which is attributable to a simple bone metastasis.
Lung, prostate, renal and breast cancer can commonly spread to the spine. GPs with any suspicion of MSCC should send the patient to a local facility (A&E or a medical assessment unit) for assessment and an urgent MRI scan.
Red flags include:
- Patients describing their pain as a different kind to what they are used to
- Pain that wakes the patient at night or increases when lying down
- Pain on sneezing, straining or going to the toilet
- Radiating pain
- Tenderness that corresponds to the area of pain
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Read NICE ‘s guidance on metastatic spinal cord compression in adults here