What is the differential diagnosis (Ddx) of low back pain?

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Last updated: February 26, 2025View editorial policy

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Differential Diagnosis for Low Back Pain

Single Most Likely Diagnosis

  • Musculoskeletal strain: This is the most common cause of low back pain, often resulting from overuse, heavy lifting, or sudden movement. It affects the muscles and ligaments in the back.

Other Likely Diagnoses

  • Herniated disc: A condition where the soft inner gel of the disc leaks out through a tear in the outer layer, putting pressure on nearby nerves and causing pain.
  • Degenerative disc disease: A condition where the spinal discs lose their cushioning ability and can cause pain due to the reduced space between the vertebrae.
  • Spondylosis: A condition characterized by the degeneration of the spinal joints, which can lead to pain and stiffness.
  • Osteoarthritis: Wear and tear on the joints in the spine, leading to pain and stiffness.

Do Not Miss Diagnoses

  • Cauda equina syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to severe pain, numbness, and potentially permanent damage if not treated promptly.
  • Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine that can cause severe pain and potentially serious complications if not treated.
  • Spinal fracture: A break in one of the vertebrae, which can be caused by osteoporosis, trauma, or cancer.
  • Abdominal aortic aneurysm: A condition where the aorta enlarges and can cause back pain, which is a medical emergency if it ruptures.

Rare Diagnoses

  • Spinal tumors: Abnormal growths in the spine that can cause pain, numbness, and weakness.
  • Spondylolisthesis: A condition where a vertebra slips out of place, which can cause pain and nerve compression.
  • Ankylosing spondylitis: A type of arthritis that affects the spine and can cause pain, stiffness, and limited mobility.
  • Paget's disease of bone: A condition that affects bone remodeling and can cause enlarged and misshapen bones, leading to pain and other complications.

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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