Differential Diagnosis for Lower Back Pain and Abdominal Pain
Single Most Likely Diagnosis
- Musculoskeletal strain: This is often the most common cause of lower back pain and can also refer pain to the abdominal region due to the shared nerve roots. Activities that involve heavy lifting, bending, or sudden movement can lead to muscle strain.
Other Likely Diagnoses
- Kidney stones: Pain from kidney stones can manifest as lower back pain that radiates to the abdomen. The pain is often severe and can be accompanied by nausea, vomiting, and blood in the urine.
- Urinary tract infection (UTI): While more common in women, UTIs can cause lower back pain and abdominal discomfort in both sexes, along with symptoms like frequent urination and burning during urination.
- Diverticulitis: Inflammation of the diverticula in the colon can cause abdominal pain, which may also be felt in the lower back. Fever, nausea, and changes in bowel habits may also be present.
- Gastrointestinal issues: Conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or gastroesophageal reflux disease (GERD) can cause abdominal pain that may radiate to the lower back.
Do Not Miss Diagnoses
- Appendicitis: Although the pain typically starts near the navel and then moves to the lower right abdomen, some cases can present with lower back pain. It's crucial to consider appendicitis due to the risk of rupture and peritonitis.
- Ectopic pregnancy: In women of childbearing age, ectopic pregnancy is a life-threatening condition that can cause lower abdominal and back pain. A missed diagnosis can lead to severe consequences.
- Aortic aneurysm or dissection: Abdominal aortic aneurysm or dissection can cause severe back and abdominal pain and is a medical emergency requiring immediate intervention.
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that radiates to the back, often accompanied by nausea and vomiting.
Rare Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic abdominal and back pain, along with hypertension and other systemic symptoms.
- Primary or metastatic tumors: Tumors in the spine, abdominal organs, or retroperitoneal space can cause both lower back and abdominal pain, often with other systemic symptoms like weight loss.
- Inflammatory arthropathies: Conditions like ankylosing spondylitis can cause lower back pain and, in some cases, abdominal symptoms due to the inflammatory nature of the disease.
- Endometriosis: In women, endometriosis can cause chronic pelvic and lower back pain, especially during menstruation, due to the growth of endometrial tissue outside the uterus.