Differential Diagnosis for Left Back Pain in Pregnancy
Single Most Likely Diagnosis
- Musculoskeletal strain: This is the most common cause of back pain in pregnancy, due to the weight gain and postural changes that occur during this period. The strain on the muscles and ligaments in the back can lead to pain, particularly on one side.
Other Likely Diagnoses
- Urinary tract infection (UTI): UTIs are common in pregnancy and can cause back pain, especially if the infection has moved up to the kidneys (pyelonephritis).
- Kidney stones: Although less common, kidney stones can cause severe back pain and are more likely to occur during pregnancy due to urinary stasis and increased calcium excretion.
- Round ligament pain: As the uterus expands, the round ligaments that support it can stretch and cause pain, often on one side of the back or abdomen.
Do Not Miss Diagnoses
- Placental abruption: This is a serious condition where the placenta separates from the uterus, causing pain and potentially life-threatening bleeding. Back pain can be a symptom, especially if the abruption occurs on the left side.
- Preeclampsia: While preeclampsia typically presents with hypertension and proteinuria, it can also cause back pain due to the involvement of the kidneys and liver.
- Appendicitis: Although the appendix is usually located on the right side, an inflamed appendix can cause referred pain to the back, and appendicitis in pregnancy can be more challenging to diagnose due to the displaced appendix.
Rare Diagnoses
- Osteoporotic vertebral fracture: Pregnancy can increase the risk of osteoporosis due to calcium demands, and vertebral fractures can cause back pain.
- Spinal epidural hematoma: A rare condition where bleeding occurs in the spinal canal, which can cause back pain and neurological symptoms.
- Pancreatitis: Inflammation of the pancreas can cause severe back pain, although it is uncommon in pregnancy unless there is a history of gallstones or other risk factors.