Differential Diagnosis for Thoracic Pain Radiating to Tailbone
- Single most likely diagnosis:
- Musculoskeletal strain: This is often the most common cause of thoracic pain that radiates down to the tailbone, typically due to strain or injury of the muscles or ligaments in the thoracic or lumbar region. The pain can be exacerbated by movement or poor posture.
- Other Likely diagnoses:
- Herniated disk: A herniated disk in the thoracic or lumbar spine can cause pain that radiates down to the tailbone, especially if the disk is compressing a nerve root.
- Spondylosis: This condition, characterized by degenerative changes in the spine, can lead to pain in the thoracic region that radiates to the lower back and tailbone.
- Fibromyalgia: Although less common, fibromyalgia can cause widespread musculoskeletal pain, including thoracic pain that radiates to the tailbone, often accompanied by other symptoms like fatigue and sleep disturbances.
- Do Not Miss diagnoses:
- Aortic dissection: A life-threatening condition where the inner layer of the aorta tears, causing severe pain that can radiate from the thoracic region down to the back and potentially to the tailbone. Immediate medical attention is crucial.
- Pulmonary embolism: While the primary symptom is usually respiratory, a pulmonary embolism can cause sudden, severe chest pain that may radiate to the back and, in rare cases, could be perceived as radiating down to the tailbone.
- Spinal infection or abscess: Infections like osteomyelitis or discitis can cause severe back pain that may radiate, including to the tailbone, and require prompt antibiotic treatment or surgical intervention.
- Rare diagnoses:
- Cauda equina syndrome: A rare condition caused by compression of the nerves in the spinal canal, leading to pain, numbness, and potentially severe neurological deficits. It's a medical emergency.
- Thoracic spine fracture: Although more common in the context of trauma, a spontaneous fracture (e.g., due to osteoporosis) can cause severe thoracic pain radiating to the lower back and tailbone.
- Referred pain from visceral organs: Certain conditions affecting abdominal or pelvic organs (e.g., pancreatitis, pelvic inflammatory disease) can cause referred pain that might be perceived as radiating from the thoracic region down to the tailbone, though this would be less common and typically accompanied by other specific symptoms related to the organ involved.