Differential Diagnosis for Lower Back Pain around the Tailbone Exacerbated by Coughing
- Single most likely diagnosis:
- Coccydynia: This condition is characterized by pain in the tailbone area, which can be exacerbated by activities that increase pressure on the coccyx, such as coughing. The pain is typically sharp and localized to the coccygeal region.
- Other Likely diagnoses:
- Pilonidal cyst or abscess: These conditions can cause pain in the lower back around the tailbone and may worsen with coughing due to increased pressure on the affected area.
- Anal fissure: An anal fissure can cause sharp pain in the anal region, which may radiate to the lower back and worsen with coughing.
- Levator ani syndrome: This condition involves pain in the muscles of the pelvic floor, which can radiate to the lower back and worsen with activities like coughing.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Cauda equina syndrome: Although rare, this condition is a medical emergency that requires prompt attention. It involves compression of the nerve roots in the lower spine, which can cause severe pain, numbness, and weakness in the legs, as well as bowel and bladder dysfunction.
- Spinal epidural abscess: This is a rare but potentially life-threatening condition that involves an abscess in the spinal canal, which can cause severe back pain, fever, and neurological deficits.
- Rectal cancer: Although less common, rectal cancer can cause pain in the lower back and around the tailbone, especially if the tumor is large or has metastasized to nearby structures.
- Rare diagnoses:
- Tarlov cyst: A rare condition characterized by fluid-filled cysts in the nerve roots of the spine, which can cause pain in the lower back and around the tailbone.
- Spinal tuberculosis: A rare infection that can cause pain and destruction of the spine, including the lower back and tailbone region.
- Chordoma: A rare type of bone cancer that can occur in the spine, including the coccyx, and cause pain and neurological symptoms.