Single most likely diagnosis
- Herniated disk: This condition is likely given the symptoms of a bulge and muscle spasm, which are common presentations of a herniated disk, especially in the lumbar or cervical spine.
Other Likely diagnoses
- Muscle strain: The feeling of muscle spasm could be indicative of a muscle strain, which is a common condition that can cause pain and a bulge due to swelling.
- Degenerative disk disease: This condition can cause chronic pain and muscle spasms, and might be considered if the patient has a history of back pain or if the symptoms persist.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cauda equina syndrome: Although less likely, this is a serious condition that requires immediate medical attention. It can present with symptoms of a bulge and muscle spasm, along with neurological deficits such as numbness, weakness, or bladder and bowel dysfunction.
- Spinal infection (e.g., abscess or osteomyelitis): Infections in the spine can cause pain, muscle spasm, and swelling, and are medical emergencies that require prompt diagnosis and treatment.
Rare diagnoses
- Spinal tumor: Although rare, tumors in the spine can cause a bulge and muscle spasm due to compression of the spinal cord or nerve roots.
- Spinal fracture: A fracture in the spine, which could be due to osteoporosis or trauma, might present with a bulge and muscle spasm, especially if there is instability or compression of neural structures.