Differential Diagnosis for Radicular Pain
- Single most likely diagnosis
- Herniated disk: This is the most common cause of radicular pain, especially in the lower back. It occurs when the soft inner gel of the disk leaks out through a tear in the outer layer, putting pressure on the spinal nerves and causing pain that radiates down the arm or leg.
- Other Likely diagnoses
- Spondylosis: This refers to degenerative changes in the spine, such as osteoarthritis, which can cause radicular pain by narrowing the spaces through which nerves exit the spine.
- Spinal stenosis: A narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, leading to radicular pain.
- Osteoporotic compression fracture: Weakened bones can lead to fractures, which may compress nerves and cause radicular pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- 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 requires immediate medical attention.
- Spinal infection (e.g., abscess or osteomyelitis): Infections in the spine can cause severe pain and neurological deficits, and if not treated promptly, can lead to serious complications.
- Spinal tumor: Both benign and malignant tumors can compress nerves and cause radicular pain. Early diagnosis is crucial for effective treatment.
- Rare diagnoses
- Arachnoiditis: Inflammation of the membranes surrounding the spinal cord, which can cause radicular pain and other neurological symptoms.
- Tarlov cysts: Fluid-filled sacs that can compress nerves and cause radicular pain, though they are often asymptomatic.
- Neurosyphilis: A complication of untreated syphilis that can cause a variety of neurological symptoms, including radicular pain, though it is relatively rare in areas with access to modern healthcare.