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 awkward movements. The pain typically presents in the lower lumbar region and can be bilateral.
Other Likely Diagnoses
- Herniated Lumbar Disc: A condition where the soft inner gel of the disc leaks out through a tear in the outer layer, potentially irritating nearby nerves and causing pain. Symptoms can include pain in the lower back that radiates to the legs.
- Degenerative Disc Disease: A condition characterized by the wear and tear of the spinal discs, leading to pain and stiffness in the lower back.
- Spondylosis: A defect in the pars interarticularis, the thin piece of bone that connects the superior and inferior articular facets of the spine. It can cause low back pain, especially in young athletes.
- Osteoarthritis of the Spine: 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 that occurs when the nerves in the spinal canal are compressed, leading to loss of bladder and bowel control, numbness in the legs, and potentially permanent nerve damage if not promptly treated.
- Spinal Infection (Osteomyelitis, Discitis): Infections of the spine that can cause severe back pain, fever, and potentially lead to serious complications if not treated.
- Spinal Fracture: A break in one of the vertebrae, which can be caused by osteoporosis, trauma, or cancer. It requires immediate medical attention to prevent further damage.
- Abdominal Aortic Aneurysm: A bulge in the main blood vessel that leads from the heart and passes through the abdomen. It can cause back pain and is a medical emergency if ruptured.
Rare Diagnoses
- Spinal Tumors: Abnormal cell growths in the spine, which can be benign or malignant. They can cause back pain, numbness, and weakness in the legs.
- Ankylosing Spondylitis: A type of arthritis that affects the spine, leading to chronic pain and stiffness.
- Spondylolisthesis: A condition where one of the vertebrae slips out of place onto the vertebra below it, potentially causing nerve compression and pain.
- Paget's Disease of the Bone: A chronic condition that can result in enlarged and misshapen bones, leading to pain and potential neurological problems if the spine is involved.