Differential Diagnosis for Pain while Sitting Down
- Single most likely diagnosis
- Hemorrhoids: Pain while sitting down is a common complaint in patients with hemorrhoids, especially if they are thrombosed. The pressure exerted on the anal region while sitting can exacerbate the pain.
- Other Likely diagnoses
- Anal fissure: Similar to hemorrhoids, an anal fissure can cause significant pain that worsens with sitting due to the increased pressure on the anal sphincter.
- Prostatitis: In men, prostatitis (inflammation of the prostate gland) can cause pain in the perineal area that may be exacerbated by sitting.
- Coccydynia: This condition, also known as tailbone pain, can occur after a fall onto the buttocks or prolonged sitting on a hard surface, leading to pain when sitting.
- 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 pain, numbness, and weakness in the legs. It can present with pain that worsens with sitting.
- Spinal infections (e.g., epidural abscess): Infections near the spine can cause severe back pain that radiates to other areas and worsens with movement or sitting.
- Testicular torsion: Although less common, testicular torsion can cause severe pain that may radiate to the groin and worsen with certain positions, including sitting.
- Rare diagnoses
- Pudendal neuralgia: A condition characterized by pain in the distribution of the pudendal nerve, which can be exacerbated by sitting.
- Levator ani syndrome: A condition that causes chronic pain in the region of the levator ani muscle, which can worsen with sitting.
- Tarlov cysts: These are rare cysts that can form on the nerve roots in the spine, potentially causing pain that worsens with sitting or certain positions.