Back, Hip, or Bone Pain: When to Get Checked

The NCI's general timing guidance is this: "If you have symptoms that do not get better after a few weeks, see your doctor so that problems can be diagnosed and treated as early as possible."

For bone pain, here are a few practical readings of that.

• Call 911 or go to an emergency department if a bone gives way under little or no force, or you cannot put weight on a limb after a minor knock. The NCI lists a bone that breaks for no known reason among the symptoms that need looking at, and a fracture is not something to wait out over a few weeks.
• Call your care team the same day if the pain comes with an unexplained fever, or with swelling or a lump over the bone. Those move it up the list rather than leaving it to settle.
• Call your care team within a day or two if pain in a bone or joint has run past a few weeks without improving, even when it is mild, or if you have a new limp or difficulty walking. If you have been treated for cancer before, say so when you book. That history changes how new bone pain is evaluated.

Back, hip, and bone pain are among the most common complaints there are, and cancer is a rare explanation for them. The National Cancer Institute states the general rule for any worrying symptom: cancer can cause many symptoms, "but these symptoms are most often caused by illness, injury, benign tumors, or other problems."

Cancer that starts in bone is rarer still. The NCI reports that primary bone cancer "is rare. It accounts for much less than 1% of all new cancers diagnosed."

That is the honest background. It does not mean pain should be ignored. The NCI is equally clear on the other side: "Persistent or unusual pain or swelling in or near a bone can be caused by cancer or by other conditions," and "it is important to see a doctor to determine the cause of any bone symptoms."

Doctors mean two different things by cancer in bone.

Primary bone cancer starts in the bone tissue itself. This is the rare one.

Metastatic bone cancer is cancer that began somewhere else in the body and spread to the bones. The NCI notes that "cancer that metastasizes (spreads) to the bones from other parts of the body is called metastatic (or secondary) bone cancer." Among the symptoms the NCI lists for metastatic cancer are "pain and fractures, when cancer has spread to the bone."

The NCI also notes that "metastatic cancer does not always cause symptoms." When symptoms do appear, "what they are like and how often you have them will depend on the size and location of the metastatic tumors."

Pain is the most common symptom of bone cancer, though not every case causes it. The features the NCI describes as worth a doctor's attention are:

• Pain in a bone or joint that is persistent or unusual.
• Swelling in or near a bone, or swelling over a bony part of the body.
• Stiffness in a joint.
• Pain in the arm when lifting.
• A limp or new difficulty walking.
• A lump.
• Unexplained fever.
• A bone that breaks for no known reason.

That last one carries weight. A bone that fractures without a fall or injury to explain it is not a normal event.

The NCI adds the sentence that matters most here: these symptoms "may be caused by osteosarcoma, UPS, or other problems. The only way to know is for your child to see a doctor." The same logic applies to adults. A symptom list cannot sort this out. An exam can.

Expect a conversation and an exam first. If your doctor wants to look further, the NCI lists these tools for evaluating bone symptoms.

• X-ray. Usually the first image of the painful area.
• CT scan, MRI, bone scan, PET scan, or angiogram. For a more detailed look at the bone and surrounding tissue.
• Blood tests. Including levels of alkaline phosphatase and lactate dehydrogenase, two enzymes that can be raised in bone disease.
• Biopsy. Removing a tissue sample from a bone tumor "to determine whether cancer is present."

A biopsy is the only test that answers the cancer question directly. Most people evaluated for bone pain never reach that step, because the x-ray and exam explain what is going on.

• What do you think is causing this pain?
• Does anything about my exam or history change the urgency?
• Should we image it now, or wait and see how it behaves?
• If this does not improve, when should I come back?

National Cancer Institute, Primary Bone Cancer, Metastatic Cancer: When Cancer Spreads, Osteosarcoma and UPS of Bone Treatment (PDQ) — Patient Version, and Symptoms of Cancer. Accessed July 28, 2026.