Pulmonary nodules do not necessarily cause back pain. Pulmonary nodules are round or irregular shaped lesions ≤3 cm in diameter in the lung, which mostly appear as hyperdense shadows in the lung field, either single or multiple, with clear or indistinct borders. The clinical manifestations of pulmonary nodules are closely related to the location, size, presence of compression, invasion of adjacent organs, and the presence of metastases, etc. Most pulmonary nodules do not cause clinical symptoms because they are mostly located inside the lung field and are not close to the pleura or trachea. Most lung nodules are found inadvertently or during chest examination and usually have no clinical manifestations. Some nodules located in the pleura or adjacent chest wall may cause coughing or chest and back pain. The chance of chest and back pain caused by pulmonary nodules is relatively small, but if back pain occurs, other diseases such as osteophytes, muscle strain, herpes zoster, etc. should be excluded. In addition to the above, if the nodule is closely related to the pleura and has invaded the pleura, or if there is local bone tissue invasion or destruction in the back, we should be alert to the possibility of malignant tumor or bone metastasis.