Differential Diagnosis for Left Side Radicular Pain
Single Most Likely Diagnosis
- Lumbar Herniated Disc (L4-L5 or L5-S1): This is the most likely diagnosis given the progression of symptoms from back pain to hip pain and then radicular pain down the left side of the thigh to the toes. The specific nerve roots involved (L4, L5, or S1) would depend on the exact location of the herniation.
Other Likely Diagnoses
- Lumbar Spondylosis: Degenerative changes in the lumbar spine can lead to foraminal stenosis, causing radicular pain. The symptoms can mimic those of a herniated disc, with pain radiating down the leg.
- Piriformis Syndrome: The piriformis muscle can compress the sciatic nerve, leading to pain, numbness, and tingling down the back of the leg. This condition might not always start with back pain but can cause hip pain and radicular symptoms.
- Lumbar Spinal Stenosis: Narrowing of the lumbar spinal canal can cause neurogenic claudication, leading to pain, weakness, or numbness in the legs, typically worsening with standing or walking.
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, among other symptoms. It is a medical emergency requiring immediate attention.
- Spinal Infection (Abscess or Osteomyelitis): Infections of the spine can cause severe back pain, fever, and neurological deficits. Early diagnosis and treatment are crucial to prevent long-term damage.
- Spinal Tumor: Tumors in the spine can compress nerves, leading to pain, weakness, and sensory changes. They can be primary (originating in the spine) or metastatic (spreading from another site).
Rare Diagnoses
- Arachnoiditis: Inflammation of the arachnoid membrane surrounding the spinal cord, which can cause severe pain, numbness, and tingling. It is often associated with previous spinal surgery, infection, or trauma.
- Tarlov Cysts: Fluid-filled sacs that can compress nerve roots, leading to pain and neurological symptoms. They are usually asymptomatic but can cause problems if they compress adjacent nerves.
- Neurogenic Tumors (e.g., Neurofibroma, Schwannoma): Benign tumors arising from nerve tissue can compress adjacent nerves, leading to radicular pain and neurological deficits.