Differential Diagnosis for Back Pain

• Single Most Likely Diagnosis
  • Musculoskeletal strain: This is the most common cause of back pain, often resulting from overuse, heavy lifting, or sudden movement. It affects the muscles and ligaments in the back.
• Other Likely Diagnoses
  • Herniated disc: A condition where the soft inner gel of the disc leaks out through a tear in the outer layer, putting pressure on nerves and causing pain.
  • Degenerative disc disease: A condition where the spinal discs lose their cushioning ability, leading to pain and stiffness.
  • Spondylosis: A condition characterized by the degeneration of the spinal joints, which can cause back pain.
  • Osteoarthritis: Wear and tear on the joints in the spine, leading to pain and stiffness.
• Do Not Miss Diagnoses
  • Spinal fracture: A break in one of the vertebrae, which can be caused by osteoporosis, trauma, or cancer.
  • Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine that can cause severe back pain and potentially serious complications.
  • Cancer (e.g., metastatic disease, multiple myeloma): Back pain can be a symptom of various types of cancer that affect the spine.
  • Cauda equina syndrome: A condition where the nerves in the lower spine are compressed, leading to severe pain, numbness, and potentially permanent damage if not treated promptly.
  • Aortic dissection or abdominal aortic aneurysm: These are life-threatening conditions that can cause back pain, often severe and sudden.
• Rare Diagnoses
  • Ankylosing spondylitis: A type of arthritis that affects the spine, leading to chronic pain and stiffness.
  • Spinal stenosis: Narrowing of the spinal canal, which can put pressure on the spinal cord and nerves.
  • Paget's disease of bone: A condition that affects bone remodeling, leading to enlarged and misshapen bones, which can cause back pain.
  • Osteoporotic compression fracture: A type of fracture that occurs when a vertebra collapses due to osteoporosis.