Differential Diagnosis for Back Pain Worsening on Sitting
- Single Most Likely Diagnosis
- Lumbar Disc Herniation: This condition is a common cause of back pain that worsens with sitting due to increased intradiscal pressure in the lumbar spine when seated.
- Other Likely Diagnoses
- Lumbar Spondylosis: Degenerative changes in the lumbar spine can lead to pain that is exacerbated by sitting due to increased stress on the facet joints and discs.
- Spinal Stenosis: Narrowing of the spinal canal can cause pain, numbness, or weakness that worsens with sitting and improves with standing or walking.
- Facet Joint Syndrome: Inflammation or degeneration of the facet joints in the lumbar spine can cause back pain that is worse with sitting.
- Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition caused by compression of the nerves in the lower spine, which can present with severe back pain, numbness, and weakness in the legs, and loss of bladder and bowel control. It is a medical emergency.
- Spinal Infection (e.g., Discitis, Osteomyelitis): Infections of the spine can cause severe back pain that worsens with sitting, along with fever, chills, and other systemic symptoms.
- Spinal Tumor: Tumors in the spine can cause back pain that worsens with sitting, along with other symptoms such as numbness, weakness, and loss of bladder or bowel control.
- Rare Diagnoses
- Ankylosing Spondylitis: A chronic inflammatory disease that can cause back pain and stiffness, which may worsen with sitting due to fusion and rigidity of the spine.
- Osteoporotic Compression Fracture: Weakened bones can lead to fractures in the spine, causing back pain that may worsen with sitting due to increased pressure on the fractured vertebrae.