Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key clinical signs and symptoms suggesting metastatic spinal cord compression (MSCC) include:
- Severe, unremitting back pain that is progressive and mechanical in nature (aggravated by standing, sitting, or moving).
- Back pain worsened by straining activities such as coughing, sneezing, or bowel movements.
- Night-time back pain that disturbs sleep.
- Localized spinal tenderness.
- Neurological symptoms such as limb weakness, numbness, paraesthesia, or sensory loss.
- Signs of spinal cord or cauda equina compression including gait disturbance or difficulty walking.
- Bladder or bowel dysfunction.
- Radicular pain and claudication (muscle pain or cramping in the legs on walking or exercising).
These features should raise suspicion of MSCC, especially in patients with a past or current diagnosis of cancer or suspected cancer, and warrant urgent assessment and referral as MSCC is an oncological emergency NICE NG234.