What are the differential diagnoses for back pain?

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Last updated: February 26, 2025View editorial policy

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Differential Diagnosis for Back Pain

The following is a list of potential diagnoses for back pain, categorized by likelihood and potential impact.

  • Single Most Likely Diagnosis
    • Musculoskeletal strain: This is the most common cause of back pain, often resulting from overuse, poor posture, or acute injury. It is typically characterized by localized pain and stiffness, with possible radiation to the buttocks or thighs.
  • Other Likely Diagnoses
    • Herniated disc: A condition where the soft inner gel of the disc leaks out, putting pressure on nearby nerves and causing pain, numbness, or weakness in the back and legs.
    • Degenerative disc disease: A condition where the spinal discs lose their cushioning ability, leading to pain and stiffness in the back.
    • Spondylosis: A condition characterized by degenerative changes in the spine, including osteoarthritis, disc degeneration, and spinal stenosis.
    • Osteoporosis: A condition where the bones become weak and brittle, increasing the risk of fractures, including vertebral compression fractures.
  • Do Not Miss Diagnoses
    • Cauda equina syndrome: A rare but serious condition where the nerves in the lower spine are compressed, leading to severe pain, numbness, and weakness in the legs, as well as bowel and bladder dysfunction.
    • Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine can cause severe back pain, fever, and other systemic symptoms.
    • Spinal tumor: Tumors in the spine can cause back pain, numbness, and weakness, and can be life-threatening if left untreated.
    • Abdominal aortic aneurysm: A condition where the aorta becomes enlarged and can rupture, causing severe back pain and potentially life-threatening bleeding.
  • Rare Diagnoses
    • Ankylosing spondylitis: A chronic inflammatory disease that can cause back pain and stiffness, as well as fusion of the spine.
    • Spinal epidural abscess: A rare but serious condition where an abscess forms in the epidural space, causing severe back pain, fever, and neurological symptoms.
    • Paget's disease: A condition where the bones become enlarged and deformed, leading to back pain and other symptoms.
    • Osteonecrosis: A condition where the bone tissue dies due to lack of blood supply, leading to back pain and other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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