Most commonly a painful lump on the back occurs when there is an underlying skin condition like a cysts, skin abscess, boil, or a pimple on the back. More serious causes of painful back bumps include lipoma and dermatofibroma. Read on for more information on causes and treatment options.
5 most common cause(s)
Painful back lump symptoms
The back is essential to everyday activities — from standing and walking to balance and posture. A painful lump in the back can be disruptive and possibly debilitating, making it important for you to understand your symptoms and treatment options.
Common characteristics of a painful back lump
The pain related to a lump in the back can be characterized in many ways, for example, pain that worsens by changing positions or pain that worsens at night. Take note of whether your pain fits the following descriptions.
- Sharp or dull
- Achy or burning
- Cramping or pounding
- Constant or intermittent
Common accompanying symptoms
A painful back lump may be associated with a variety of conditions. As a result, in addition to pain, you may experience many other symptoms such as:
- Fever
- Redness
- Blistering
- Tenderness to the touch
- Changes in the appearance of the lump
- Changes in urinary frequency or color
- Dysuria: This is pain with urination.
- Numbness or loss of sensation in the back or lower legs
- Muscle weakness: This may occur in the legs or other parts of the body.
- Difficulty walking
You should see a doctor if you continue to experience any of these symptoms in order to receive a proper diagnosis and treatment.
6 painful back lump causes
The following details may help you better understand your symptoms. Most causes of painful back lumps can be treated after a proper diagnosis is determined by a physician, which may require a biopsy.
Inflammatory causes
Inflammatory conditions trigger the body’s natural immune response.
- Infections: The skin is home to many different bacterial pathogens and is susceptible to infections from cuts or lesions. Serious infections can form fluid-filled cysts or pus-filled abscesses that cause blockage and resultant swelling. Furthermore, when the hair follicles become infected by bacteria or fungus, they can become inflamed and turn into small, red bumps or pimples that can grow and swell without treatment. This specific type of infection is known as folliculitis and can be caused by many different bacteria, fungi, and viruses.
- Dermatologic: There are many dermatologic conditions that can result in a painful lump or lumps on the back. Skin conditions such as eczema or acne can cause inflammation on the back. Deeper bumps, called boils, can merge together to form clusters known as carbuncles. This dermatologic inflammation can cause multiple bumps that result in excessive itching, tenderness, and pain.
- Rheumatologic: Cysts are sacs that can be filled with fluid, air, or other material and can form in any part of the body.
Traumatic causes
Traumatic causes of painful back lumps are associated with injury to the back.
- Direct: Trauma to the back from both minor and serious events can result in painful back lumps. Traumatic causes may also be associated with visible deformity and bleeding, depending on the severity of the trauma.
- Repetitive: The back is susceptible to injury from repetitive movements that can cause small injury but result in significant pain. Mechanical or anatomical problems within the back, and how it interacts with other joints, may result in irritation or a painful lump.
Growths
A lump in the back is usually the result of the growth of underlying structures in the back, which may be benign (non-cancerous) or malignant (cancerous). These lumps are not usually associated with pain; however, this can be a presenting symptom. There are various specific structures within the back, including the following.
- Nerves: The back is home to the spinal cord, the body’s central support structure and relay center for messages going to and from the body and brain. The nerves that arise from the spinal column provide sensation and allow movement of different parts of the body.
- Muscles: There are many muscles in the back, both superficial and deep. These muscles allow you to bend, stand, twist, and lift. Extensor muscles help hold the body upright, flexor muscles help you bend, and oblique muscles help you rotate.
- Fat: There is a layer of fatty tissue under the skin that stores energy, regulates the body’s temperature, and serves as a protective cushion. Growths of the fat and soft tissue of the skin are known as lipomas and often present as soft, round, painless nodules. They most commonly occur on the back and upper extremities but can appear in other locations.
- Lymphatics: The lymphatic system helps rid the body of waste and toxins. It includes a network of tissues and structures both in the body and underneath the skin, such as lymph nodes, that play an important role in fighting off infections.
- Skin: It may seem obvious, but the skin is an important organ to the entire body and is often the most common etiology of bumps and lumps on the skin.
Skin abscess
A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.
Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.
If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.
Diagnosis is made through physical examination.
A small abscess may heal on its own, through the body's immune system. But some will need to be drained or lanced in a medical provider's office so that the pus can be cleaned out. Antibiotics are usually prescribed.
Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.
Rarity: Common
Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash
Symptoms that always occur with skin abscess: rash with bumps or blisters
Urgency: Primary care doctor
Severe skin abscess
A skin abscess is an infection of the deeper skin that's typically due to bacteria seen on the skin. Recently, infections are more frequently caused by Staph. Aureus (puts the "staph" in "staph infections"). If the infection begins to spread, urgent treatment is required.
You should head to the nearest ER by car since your infection seems like it might be spreading. It is likely that you will be prescribed antibiotics. Surgery may be required to get rid of the whole abscess after the inflammation has died down. Do not drain the abscess yourself.
Rarity: Rare
Top Symptoms: fatigue, fever, painful neck lump, marble-size neck lump, pink or red neck bump
Symptoms that always occur with severe skin abscess: pink or red neck bump, red bump
Urgency: Hospital emergency room
Pimple
Pimples are also called comedones, spots, blemishes, or "zits." Medically, they are small skin eruptions filled with oil, dead skin cells, and bacteria.
Pimples often first start appearing at puberty, when hormones increase the production of oil in the skin and sometimes clog the pores.
Most susceptible are teenagers from about ages 13 to 17.
Symptoms include blocked pores that may appear flat and black on the surface, because the oil darkens when exposed to the air; blocked pores that appear white on the surface because they have closed over with dead skin cells; or swollen, yellow-white, pus-filled blisters surrounded by reddened skin.
Outbreaks of pimples on the skin can interfere with quality of life, making the person self-conscious about their appearance and causing pain and discomfort in the skin. A medical provider can help to manage the condition, sometimes through referral to a dermatologist.
Diagnosis is made through physical examination.
Treatment involves improving diet; keeping the skin, hair, washcloths, and towels very clean; and using over-the-counter acne remedies.
Rarity: Common
Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump
Symptoms that always occur with pimple: pink or red facial bump
Urgency: Self-treatment
Lipoma
Lipoma is a word that translates as "fatty tumor," but a lipoma is not cancer. It is simply a growth of fat between the muscle layer and the skin above it.
The exact cause is not known. The condition does run in families and is associated with other unusual syndromes such as adiposis dolorosa, which is similar. Lipomas most often appear after age 40.
Symptoms include a soft, easily moveable lump beneath the skin, about two inches across. A lipoma is painless unless its growth is irritating the nerves around it. They are most often found on the back, neck, and abdomen, and sometimes the arms and upper legs.
It is a good idea to have any new or unusual growth checked by a medical provider, just to make certain it is benign.
Diagnosis is made through physical examination, biopsy, and imaging such as ultrasound or CT scan.
Most of the time, treatment is not necessary unless the lipoma is unsightly or is interfering with other structures. It can be removed through surgery or liposuction.
Rarity: Uncommon
Top Symptoms: skin-colored groin bump, marble sized groin lump, small groin lump
Symptoms that always occur with lipoma: skin-colored groin bump
Urgency: Wait and watch
Dermatofibroma
A dermatofibroma is a fairly common skin growth that usually appears on the lower legs, but may appear anywhere on the body. These mole-like growths are benign (noncancerous.)
The cause is not known, though a dermatofibroma may appear after a minor injury. The growths are not contagious.
Dermatofibromas are most common in adults and are rarely found in children.
Symptoms include a hard, raised growth that is red, pink, or brown and less than half an inch across. They are usually painless but may be tender or itchy, and may appear alone or in groups.
Any new growth on the skin should be seen by a medical provider, especially if the growth is very dark in color or changes its shape or appearance quickly.
Diagnosis is made through physical examination and sometimes biopsy.
A dermatofibroma does not require treatment unless it is interfering with clothing or is unsightly. They can be surgically removed, though this will leave a scar and the growth may eventually return.
Boil (furuncle)
A furuncle, also called a boil, is infection of a hair follicle. The infection forms under the skin at the root of the hair and may occur anywhere on the body.
The infection is caused by bacteria, most often Staphylococcus aureus or "staph." Irritation caused by clothes or anything else rubbing the skin can cause the skin to break down and allow bacteria to enter.
Staph bacteria are found everywhere. Frequent and thorough handwashing, and otherwise maintaining cleanliness, will help to prevent its spread.
Most susceptible are those with a weakened immune system; diabetes; and other skin infections.
Symptoms include a single bump under the skin that is swollen, painful, and red, and contains pus.
It is important to treat the boil, since infection can spread into the bloodstream and travel throughout the body.
Diagnosis is made through physical examination and sometimes fluid sample from the boil.
Treatment may involve incision and drainage of the infection, followed by creams to apply to the site of the boil and/or a course of antibiotic medicine.
Rarity: Uncommon
Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump, constant skin changes
Symptoms that always occur with boil (furuncle): pink or red facial bump
Symptoms that never occur with boil (furuncle): fever
Urgency: Self-treatmen
Painful back lump treatments and relief
At-home treatments
In the meantime, supportive measures such as rest and ice, as well as warm, compressive bandages may help alleviate swelling and discomfort. If your painful back lump lessens or goes away with these supportive measures, your condition is most likely benign.
When to see a doctor
It is important to make an appointment with your physician to get a proper diagnosis and treatment for a painful back lump that does not seem to be resolving. Depending on the cause of your symptoms, your physician may suggest the following.
- Surgery: Surgery is often the first-line option for removing both benign and malignant growths. Surgery for malignant growths is also often combined with other chemical treatments.
- Pain medication: Medications such as NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin) may help alleviate pain and swelling.
- Anti-inflammatory: Inflammatory causes of painful back lumps may be treated with various types of medications that target and decrease inflammation, including immune system suppressing drugs.
- Cancer treatment: If your painful back lump and associated symptoms are due to malignant cancer, your physician will discuss treatment options including surgery, radiation, or chemotherapy.
When it is an emergency
If you experience back pain or injury that results in numbness or loss of sensation in the lower legs, seek medical attention immediately. This may be the first sign of cauda equina syndrome, which is damage to the nerve roots of the lower body. These nerves are very important to multiple functions of the lower body and should be examined immediately if this is a suspected cause.
Prevention
It is very difficult to prevent the development of back lumps. Back lumps are possibly preventable in cases of repetitive injury. Try to limit activities that require a lot of twisting or pressure on the back.
Painful back lump treatment quiz
Take a quiz to find out how to treat your symptoms.
FAQs about painful back lump
Will the lump on my back go away on its own?
There is a possibility that the lump and the accompanying pain will go away on its own. If the back lump is a cyst or caused by trauma or repetitive injury, the likelihood that it will go away on its own is high. However, if the painful back lump is a benign or malignant tumor, it will not resolve on its own and will require follow-up.
Can I lay down on a back bump?
Sometimes back bumps may be so painful and uncomfortable that activities such as lying down may be very difficult. However, sometimes they can be almost unnoticeable in certain positions. If you can tolerate lying directly on your back, it is okay to do so.
How will a painful back bump affect how I walk?
Most of the time, bumps on the back are benign and involve the superficial skin. However, depending on the cause and location of your back bump, your gait may be affected. If your back bump is a growth of the spinal cord, the nerves that assist in walking may be damaged or compressed. If you experience clumsiness, trouble walking, fatigue, or unexplained weight loss, make an appointment with your a physician promptly.
Will it be difficult for me to exercise with a painful back bump?
Exercise is often the main therapy for back lumps related to cancerous processes, especially if they affect the nerves and cause pain or weakness in the arms and legs. Physical therapy can help alleviate some symptoms and hasten recovery.
Will my painful back bump grow larger?
A back bump may grow in size, depending on the cause. In the cases of cancerous growths, such as melanoma or soft tissue sarcoma, growth and spread are common.
Questions your doctor may ask about painful back lump
- What color is the bump?
- Has anyone in your family had cancer?
- Do you purposely tan (using sun, tanning beds, or UV rays)?
- Is there anything on the surface of the bump?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Anatomy of the Spine. Cedars-Sinai. Cedars-Sinai Link
- Touyz LZG. Humps and bumps: Feel them ... like it or lump it. Current Oncology. 2012;19(3):e115-6. NCBI Link
- Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Boils and carbuncles: Overview. 2018 Jun 14. NCBI Link
- Soft tissue masses. UW Medicine: Orthopaedics and Sports Medicine. UW Medicine Link