Differential Diagnosis for Strange Pain in Vertebral Line
When considering the symptoms of strange pain in the vertebral line (whole spine area) triggered by the act of swallowing (specifically mentioned as "bite of roti passes through"), several potential diagnoses come to mind. These can be categorized as follows:
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition involves stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of the esophagus, causing discomfort. Pain in the chest and upper back, especially after eating, is a common symptom. The act of swallowing could exacerbate the reflux, leading to pain.
Other Likely Diagnoses
- Esophageal Spasm: This condition involves abnormal muscle contractions of the esophagus, which can cause chest pain and difficulty swallowing. The pain can radiate to the back and may be triggered by swallowing.
- Diffuse Idiopathic Skeletal Hyperostosis (DISH): Although more commonly associated with stiffness and limited mobility, DISH can cause pain in the spine. However, its connection to swallowing is less direct and might be considered if other symptoms like stiffness are present.
- Spondylosis or Spondylolisthesis: These conditions affect the spine and can cause back pain. While they might not directly relate to the act of swallowing, if the spine is unstable or if there's nerve compression, certain movements or actions (including swallowing) might exacerbate the pain.
Do Not Miss Diagnoses
- Esophageal Cancer: Although rare, esophageal cancer can cause pain that worsens with swallowing. It's crucial to rule out this diagnosis, especially in individuals with risk factors such as a history of smoking or alcohol use.
- Aortic Dissection: This is a serious condition where there is a tear in the aorta's inner layer. It can cause severe, tearing chest pain that radiates to the back. While it's not directly related to swallowing, the pain can sometimes be exacerbated by movements or actions that increase blood pressure, potentially including swallowing.
Rare Diagnoses
- Eosinophilic Esophagitis: An inflammatory condition of the esophagus that can cause difficulty swallowing and chest pain. It's more common in individuals with allergies or asthma.
- Osteoporosis: While not directly related to swallowing, osteoporosis can cause vertebral fractures, leading to back pain. The connection to swallowing would be indirect, possibly related to the movement or position during eating.
- Spinal Tumors: Tumors on the spine can cause back pain. Like osteoporosis, the connection to swallowing would be indirect, unless the tumor affects nerves that somehow relate to the swallowing mechanism.