Differential Diagnosis for Low Back Pain
Single Most Likely Diagnosis
- Musculoskeletal Strain: This is the most common cause of low back pain, often resulting from overuse, heavy lifting, or sudden awkward movements. 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, potentially pressing on nerves and causing pain.
- Degenerative Disc Disease: A condition where the spinal discs lose their cushioning ability due to wear and tear, leading to pain and stiffness.
- Spondylosis: A defect in the pars interarticularis, the thin piece of bone that connects the superior and inferior articular facets of the spine, which can lead to low back pain.
- Osteoarthritis: Wear and tear of the spinal joints, leading to pain and stiffness in the lower back.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition where 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., Osteomyelitis, Discitis): Infections of the spine that can cause severe back pain and require prompt antibiotic treatment.
- Spinal Fracture: A break in one of the vertebrae, which can be caused by osteoporosis, trauma, or cancer, and requires immediate medical evaluation.
- Cancer: Tumors in the spine can cause back pain and are a critical diagnosis not to miss.
Rare Diagnoses
- Ankylosing Spondylitis: A form of arthritis that primarily affects the spine, although it can also affect other joints. It leads to severe, chronic pain and discomfort.
- Spondylolisthesis: A condition where one of the vertebrae slips out of place onto the vertebra below it, which can cause lower back pain.
- Paget's Disease of Bone: A chronic condition that can result in enlarged and misshapen bones due to abnormal bone destruction and regrowth, potentially affecting the spine and causing pain.
- Spinal Stenosis: Narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, leading to pain and other symptoms.