Differential Diagnosis for Left Lower Back Pain
Single Most Likely Diagnosis
- Musculoskeletal strain: This is the most common cause of lower back pain, often resulting from overuse, heavy lifting, or sudden movement. The 2-week duration suggests an acute or subacute condition, which aligns with musculoskeletal strain.
Other Likely Diagnoses
- Lumbar disc herniation: Herniation of the lumbar discs can cause pain in the lower back, which may radiate to the legs. The pain can be unilateral, depending on the location and size of the herniation.
- Degenerative disc disease: Wear and tear on the spinal discs can lead to chronic back pain. While it's more common in older adults, it can occur in younger individuals, especially with a history of heavy lifting or smoking.
- Spondylosis or spondylolisthesis: These conditions involve defects in the pars interarticularis (a part of the vertebrae) and can cause lower back pain, especially in adolescents and young adults.
Do Not Miss Diagnoses
- Kidney stone: A stone in the left ureter can cause severe, sharp pain in the left lower back that may radiate to the groin. Although less common, it's a critical diagnosis not to miss due to the potential for severe complications if left untreated.
- Pyelonephritis or kidney infection: An infection of the kidney can cause flank pain, fever, and other systemic symptoms. It's essential to diagnose and treat promptly to prevent complications like sepsis.
- Aortic aneurysm or dissection: Although rare, an abdominal aortic aneurysm or dissection can present with sudden, severe back pain and is a medical emergency requiring immediate attention.
Rare Diagnoses
- Spinal tumor: Tumors in the spine, whether primary or metastatic, can cause back pain. The pain is often constant and progressive, and other symptoms like weight loss, fever, or neurological deficits may be present.
- Inflammatory spondyloarthropathies (e.g., ankylosing spondylitis): These conditions can cause chronic back pain and stiffness, especially in younger individuals. They are less common but should be considered in the differential diagnosis, especially with a history of inflammatory bowel disease, psoriasis, or uveitis.
- Osteomyelitis or discitis: Infections of the bone or disc can cause back pain, fever, and other systemic symptoms. These conditions are rare but serious and require prompt diagnosis and treatment to prevent long-term damage.