Differential Diagnosis for Lower Back Pain
Single Most Likely Diagnosis
- Musculoskeletal Strain: This is the most common cause of lower back pain, often resulting from overuse, heavy lifting, or sudden awkward movements. 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, potentially pressing on nerves and causing pain.
- Degenerative Disc Disease: A condition where the spinal discs lose their cushioning ability due to wear and tear, leading to pain and stiffness.
- Spondylosis: A defect in the pars interarticularis, the thin piece of bone that connects the superior and inferior articular facets of the spine, which can lead to lower back pain.
- Osteoarthritis: Wear and tear of the spinal joints, leading to pain and stiffness in the lower back.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to loss of bladder and bowel control, among other symptoms. Immediate medical attention is required.
- Spinal Infection (e.g., Osteomyelitis, Discitis): Infections of the spine that can cause severe back pain and require prompt antibiotic treatment.
- Spinal Fracture: A break in one of the vertebrae, which can be caused by osteoporosis, trauma, or cancer, and requires immediate medical evaluation.
- Abdominal Aortic Aneurysm: A swelling of the main blood vessel that leads from the heart and passes through the abdomen, which can cause lower back pain and is life-threatening if ruptured.
Rare Diagnoses
- Spinal Tumors: Abnormal cell growths in the spine, which can be benign or malignant and cause back pain.
- Paget's Disease of Bone: A condition that affects bone remodeling, leading to enlarged and misshapen bones, which can cause lower back pain.
- Ankylosing Spondylitis: A type of arthritis that affects the spine, leading to inflammation and eventual fusion of the vertebrae.
- Spondylolisthesis: A condition where one of the vertebrae slips out of place onto the vertebra below it, which can cause lower back pain and nerve compression.