Differential Diagnosis for Back Pain that Worsens as the Day Goes On
Single Most Likely Diagnosis
- Mechanical Low Back Pain: This is the most common cause of back pain that worsens throughout the day, often due to strain from daily activities, poor posture, or muscle fatigue. The pain typically improves with rest.
Other Likely Diagnoses
- Degenerative Disc Disease: Wear and tear on the spinal discs can cause back pain that worsens with activity and improves with rest. This condition is common in older adults.
- Spondylosis: A defect in the pars interarticularis, the thin piece of bone that connects the superior and inferior articular facets of the spine, can cause back pain, especially in adolescents and young adults.
- Herniated Disc: A disc that bulges out between the vertebrae can put pressure on nerves, causing back pain that worsens with activity.
- Spinal Stenosis: Narrowing of the spinal canal can cause back pain, numbness, and weakness, especially in older adults.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition where the nerves in the spinal canal are compressed, causing severe back pain, numbness, and weakness in the legs, as well as bladder and bowel dysfunction. Prompt surgical intervention is often necessary.
- Spinal Infection (e.g., Osteomyelitis, Discitis): Infections of the spine can cause severe back pain, fever, and other systemic symptoms. Early diagnosis and treatment are crucial to prevent serious complications.
- Spinal Tumor: Tumors in the spine can cause back pain, numbness, and weakness, and may be life-threatening if left untreated.
Rare Diagnoses
- Ankylosing Spondylitis: A chronic inflammatory disease that can cause back pain and stiffness, especially in young adults.
- Scheuermann's Kyphosis: A rare condition that causes an abnormal curvature of the spine, leading to back pain and stiffness, especially in adolescents.
- Osteoporotic Compression Fracture: A fracture of the vertebrae due to osteoporosis, which can cause sudden and severe back pain.