Differential Diagnosis for Headache, Fatigue, and Back Pain
- Single Most Likely Diagnosis
- Tension headache or musculoskeletal strain: This is often the most common cause of headache, fatigue, and back pain, typically resulting from stress, poor posture, or overexertion.
- Other Likely Diagnoses
- Fibromyalgia: A chronic condition characterized by widespread musculoskeletal pain, fatigue, and tender points, which could explain the combination of symptoms.
- Depression: Can manifest with somatic symptoms such as headache, fatigue, and back pain, especially in cases where psychological symptoms are not prominent.
- Anemia: Fatigue and headache can be symptoms of anemia, and back pain might be related to the underlying cause of the anemia (e.g., heavy menstrual bleeding).
- Hypothyroidism: Although more commonly associated with fatigue and musculoskeletal symptoms, hypothyroidism can also cause headaches and back pain.
- Do Not Miss Diagnoses
- Subarachnoid hemorrhage: Although less likely, a sudden, severe headache (often described as "the worst headache of my life") could indicate a subarachnoid hemorrhage, which is life-threatening and requires immediate medical attention.
- Meningitis: Infection of the meninges can cause headache, fever, and stiffness, and while back pain is not a primary symptom, it could be present due to the patient's position or discomfort.
- Spinal epidural abscess: A serious condition that can cause back pain, fever, and neurological deficits, with headache and fatigue possible due to systemic infection.
- Multiple myeloma: A type of blood cancer that can cause back pain due to bone lesions, fatigue due to anemia, and headache due to hypercalcemia or vertebral fractures.
- Rare Diagnoses
- Temporomandibular joint disorder: Could cause headache and might contribute to fatigue and back pain if the patient has altered posture or movement patterns.
- Sjögren's syndrome: An autoimmune disorder that can cause musculoskeletal pain, fatigue, and headache, among other symptoms.
- Polymyalgia rheumatica: Characterized by muscle pain and stiffness, primarily in the shoulders and hips, which could be accompanied by headache and fatigue.
- Chronic fatigue syndrome: A condition of profound fatigue that is not improved by rest and worsens with physical or mental activity, which might also include headache and back pain as part of its symptomatology.