Differential Diagnosis for Back Pain The patient's presentation of back pain following sudden movement, with exacerbation by motion and relief from NSAIDs, can be evaluated using the following differential diagnosis:
Single most likely diagnosis
- Musculoskeletal strain: This is the most probable diagnosis, given the patient's sudden movement leading to back pain. The pain is exacerbated by motion, which is consistent with muscle strain, and relief from NSAIDs further supports this diagnosis, as these medications are effective in reducing inflammation and pain associated with musculoskeletal injuries.
Other Likely diagnoses
- Herniated disc: This condition can cause back pain, especially if the herniation is affecting a nerve root. The pain can be exacerbated by motion and may be relieved by NSAIDs.
- Degenerative disc disease: This condition can cause chronic back pain, which may be exacerbated by sudden movement. While it's more chronic, acute exacerbations can occur.
- Facet joint syndrome: This condition involves inflammation of the facet joints, which can cause back pain that worsens with motion.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Spinal fracture: Although less likely, a spinal fracture could occur due to sudden movement, especially in osteoporotic patients. It's crucial to consider this diagnosis to avoid missing a potentially serious condition.
- Cauda equina syndrome: This is a rare but serious condition that requires immediate medical attention. It involves compression of the nerves in the lower spine, leading to severe back pain, numbness, and potentially permanent damage if not promptly treated.
- Infection (e.g., osteomyelitis, discitis): Infections of the spine can cause back pain and are more serious, requiring prompt diagnosis and treatment to avoid serious complications.
Rare diagnoses
- Spinal tumor: Although rare, tumors of the spine can cause back pain. The pain is often constant and not necessarily exacerbated by motion, but it's essential to consider this possibility, especially if other symptoms are present, such as weight loss or neurological deficits.
- Aortic dissection: This is a rare but life-threatening condition that can cause severe back pain. It typically presents with severe, tearing chest pain but can also cause back pain if the dissection extends to the abdominal aorta.