Oh this is a pain in both senses.  Unfortunately there is no easy way to
discriminate between various regular back complaints which are common
among our typical age range, and spinal metastasis.  To diagnose this
requires an isotope bone scan and a x-ray of the suspect area.  Because
of the radiation burden to your body, the cost of isotope scans, and the
commonness of back complaints, doctors are reluctant to order these
tests until other causes have been ruled out.  This probably means
trying the usual responses such as physiotherapy and NSAIDS first, and
only if there is no response, then look for mets.

On the other hand, if the primary tumour was locally advanced, eg stage
III, then it would be normal for the oncologist to order a 'baseline'
scan soon after the completion of treatment, so if she is in this
position and has not had such a scan, an early test might be more
forthcoming.

Received wisdom is that early treatment of metastases does not give any
advantage over treating symptoms as they occur, and so unlike primary
tumours there is no rush to diagnose metastases.  However as secondary
cancer becomes seen more as a chronic disease than a terminal one, in
some cases this view is not entirely justified.

Tim Jackson

Second what Tim said -- you really need to talk to your doctor, and a
bone scan would probably be definitive.  In constrast to Tim (who's in
the UK and I'm in the US, which may make a difference), my docs have
been quick to order bone scans in response to various body pains.  (This
quickness is *not* necessarily a good thing, BTW -- it has pluses &
minuses.)

One personal note:  During and since chemo, I've had back problems of
one sort or another pretty much all the time. (Multiple bone scans, all
normal, not to mention back x-rays, etc.) I think the stress of chemo on
my body, plus the inactivity during chemo, may have contributed to the
problems.

So, suggest your wife get that checked out.  If, as we all hope, it is
not directly cancer-related, some things that can help are exercise (of
the right sort), stretching, massage therapy, osteopathic (or
chiropractic) manipulation.  I do *not* recommend trying those before
checking with your doc -- some are not a good idea in the unlikely event
it is bone or spinal mets.

Let us know how things come out, OK?  Hoping for a happy resolution,

Ann T.
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