Differential Diagnosis for Sudden Onset Left Back Pain in Pregnancy
Single Most Likely Diagnosis
- Musculoskeletal strain: This is often due to the changing posture and increased weight during pregnancy, which can put additional strain on the back muscles, leading to sudden onset pain.
Other Likely Diagnoses
- Urinary tract infection (UTI): UTIs are common in pregnancy due to physiological changes that can predispose women to infection. Sudden onset back pain, especially if accompanied by other symptoms like dysuria or frequent urination, could indicate a UTI.
- Kidney stones: While not as common as in the non-pregnant population, kidney stones can occur during pregnancy and cause severe, sudden onset back pain, often radiating to the groin.
- Round ligament pain: As the uterus expands, the round ligaments can stretch, causing sharp pains on either side of the abdomen or back.
Do Not Miss Diagnoses
- Placental abruption: This is a serious condition where the placenta separates from the uterus, which can cause sudden, severe back pain, among other symptoms. It is a medical emergency.
- Pulmonary embolism: Although less common, pulmonary embolism is a potentially life-threatening condition that can cause sudden onset back pain, especially if the embolism is located in the upper lobes of the lungs.
- Pre-eclampsia with HELLP syndrome: In rare cases, pre-eclampsia can lead to HELLP syndrome, characterized by hemolysis, elevated liver enzymes, and low platelet count. Back pain can be a symptom, along with more typical symptoms like hypertension and proteinuria.
Rare Diagnoses
- Spontaneous spinal epidural hematoma: A rare condition where there is bleeding into the space outside the sac that contains the spinal fluid and nerves, which can cause sudden back pain and neurological symptoms.
- Osteoporotic vertebral fracture: Although rare in pregnancy, osteoporotic fractures can occur, especially in women with pre-existing osteoporosis or those on long-term corticosteroid therapy.
- Pancreatitis: Inflammation of the pancreas can cause severe, sudden onset back pain, usually accompanied by abdominal pain and other gastrointestinal symptoms.