Differential Diagnosis for Backache

• Single most likely diagnosis
  • Musculoskeletal strain: This is the most common cause of backache, often resulting from overuse, poor posture, or minor injuries. It is likely due to the high prevalence of musculoskeletal issues in the general population.
• Other Likely diagnoses
  • Herniated disc: A common condition where the soft inner gel of the disc leaks out, putting pressure on nerves and causing back pain.
  • Degenerative disc disease: A condition where the spinal discs lose their cushioning ability, leading to back pain.
  • Osteoarthritis: Wear and tear on the joints of the spine can cause back pain.
  • Scoliosis: Abnormal curvature of the spine can lead to back pain.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Spinal cord compression: A serious condition where the spinal cord is compressed, potentially leading to paralysis or loss of bladder and bowel function.
  • Cauda equina syndrome: A condition where the nerves in the lower spine are compressed, potentially leading to permanent nerve damage.
  • Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine can be life-threatening if not treated promptly.
  • Cancer (e.g., metastatic disease, multiple myeloma): Although rare, cancer can cause back pain and is a critical diagnosis not to miss.
• Rare diagnoses
  • Ankylosing spondylitis: A chronic inflammatory disease that can cause back pain and stiffness.
  • Spinal stenosis: Narrowing of the spinal canal, which can cause back pain and leg weakness.
  • Osteoporotic compression fracture: Weakened bones can lead to fractures, causing back pain.
  • Paget's disease: A condition that affects bone remodeling, potentially leading to back pain.