Differential Diagnosis for Low Back Pain while Urinating
Single most likely diagnosis
- Urinary Tract Infection (UTI): This is the most likely diagnosis as UTIs are common and can cause lower back pain, especially when urinating. The pain is usually due to the infection's spread to the kidneys (pyelonephritis).
Other Likely diagnoses
- Kidney Stones: Kidney stones can cause severe pain in the lower back that radiates to the groin area and can worsen while urinating. The pain is usually colicky in nature.
- Prostatitis: In men, prostatitis (inflammation of the prostate gland) can cause lower back pain, painful urination, and other urinary symptoms.
- Interstitial Cystitis: This is a chronic condition that causes bladder pressure, bladder pain, and sometimes lower back pain, especially when the bladder is full or during urination.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pyelonephritis with Sepsis: If a UTI spreads to the kidneys and causes sepsis, it can be life-threatening. Symptoms may include high fever, chills, and severe back pain.
- Spinal Epidural Abscess: Although rare, a spinal epidural abscess can cause severe back pain and neurological symptoms. If not treated promptly, it can lead to paralysis or death.
- Testicular Torsion: While more commonly associated with acute testicular pain, testicular torsion can sometimes present with lower back pain and should be considered in the differential diagnosis for acute scrotal pain.
Rare diagnoses
- Pudendal Neuralgia: A rare condition characterized by chronic pain in the distribution of the pudendal nerve, which can include the lower back, perineum, and genital area.
- Cauda Equina Syndrome: A rare condition where the nerves in the spinal canal are compressed, causing lower back pain, urinary retention or incontinence, and other neurological symptoms.
- Spinal Metastasis: Cancer that has spread to the spine can cause lower back pain, which may worsen with activities like urination due to increased intrathoracic pressure.