Differential Diagnosis for Low Back Pain with Numbness and Tingling that Improves with Walking and Standing
- Single Most Likely Diagnosis
- Spinal Stenosis: This condition is characterized by the narrowing of the spinal canal, which can cause low back pain, numbness, and tingling in the legs. Symptoms often improve with walking and standing, as these positions can help increase the diameter of the spinal canal, reducing pressure on the spinal cord and nerves.
- Other Likely Diagnoses
- Degenerative Spondylolisthesis: This condition involves the slipping of one vertebra over another, which can cause low back pain and neurological symptoms. Like spinal stenosis, symptoms may improve with walking and standing due to the dynamic nature of the spine and how positions can affect nerve compression.
- Lumbar Disc Protrusion or Herniation: While more commonly associated with worsening symptoms upon standing or walking due to increased intradiscal pressure, some patients may experience relief in these positions, especially if the disc issue is not severely compressing nerves.
- Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition that occurs when the nerves in the spinal canal are compressed, leading to severe pain, numbness, tingling, and potentially bladder and bowel dysfunction. Early recognition and treatment are crucial to prevent permanent neurological damage.
- Spinal Epidural Abscess: An infection that can cause severe back pain, neurological deficits, and systemic symptoms like fever. Prompt diagnosis and treatment are essential to avoid serious complications, including paralysis and death.
- Rare Diagnoses
- Arachnoiditis: Inflammation of the membranes surrounding the spinal cord, which can cause chronic pain, numbness, and tingling. It's a rare condition but should be considered in patients with persistent and severe symptoms.
- Tarlov Cysts: Abnormal fluid-filled sacs that can compress spinal nerves, leading to pain, numbness, and tingling. They are relatively rare and often asymptomatic but can cause significant symptoms if they compress nearby nerves.