Differential Diagnosis for Definite Nighttime Back Pain
- Single most likely diagnosis
- Musculoskeletal strain or sprain: This is often the most common cause of nighttime back pain, resulting from overuse, poor posture, or injury to the muscles and ligaments in the back.
- Other Likely diagnoses
- Herniated disc: A herniated disc can cause nighttime back pain, especially if the disc is pressing on a nerve root, leading to pain that worsens at night.
- Degenerative disc disease: As discs degenerate, they can cause pain, especially at night, due to the loss of cushioning and support for the spine.
- Osteoarthritis: Spinal osteoarthritis can cause nighttime back pain due to the wear and tear of the joints in the spine.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine can cause severe nighttime back pain and are medical emergencies that require prompt treatment.
- Spinal tumor or cancer: Tumors or cancer in the spine can cause nighttime back pain and are critical to diagnose early for effective treatment.
- Fracture: A spinal fracture, especially in individuals with osteoporosis, can cause nighttime back pain and requires immediate medical attention.
- Aortic dissection or aneurysm: Although rare, an aortic dissection or aneurysm can cause severe back pain that worsens at night and is a life-threatening condition.
- Rare diagnoses
- Spondylolisthesis: A condition where a vertebra slips out of place, which can cause nighttime back pain, although it is less common.
- Spinal stenosis: Narrowing of the spinal canal can cause nighttime back pain, especially in older adults, but it is less likely to be the primary cause.
- Paget's disease: A rare bone disease that can cause nighttime back pain due to the abnormal breakdown and regrowth of bone tissue.