Differential Diagnosis for Lower Back Pain
- Single most likely diagnosis
- Musculoskeletal strain: This is the most common cause of lower back pain, often resulting from overuse, heavy lifting, or sudden movement. It is likely due to the high prevalence of musculoskeletal issues in the general population.
- Other Likely diagnoses
- Herniated disc: A condition where the soft inner gel of the disc leaks out, putting pressure on nearby nerves and causing pain. This is a common cause of lower back pain, especially in individuals with a history of heavy lifting or trauma.
- Degenerative disc disease: A condition where the spinal discs lose their cushioning ability, leading to pain and stiffness. This is a common condition in older adults.
- Spondylosis: A condition where the vertebrae in the spine become worn and arthritic, leading to pain and stiffness. This is a common condition in older adults.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cauda equina syndrome: A rare but serious condition where the nerves in the lower spine become compressed, leading to loss of bladder and bowel control, as well as numbness and weakness in the legs. This condition requires immediate medical attention.
- Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine can cause severe back pain and require prompt antibiotic treatment. Delayed diagnosis can lead to serious complications.
- Spinal fracture: A fracture of the vertebrae can cause severe back pain and require immediate medical attention. This is especially important in individuals with osteoporosis or a history of trauma.
- Cancer (e.g., metastatic disease, multiple myeloma): Although rare, cancer can cause lower back pain and requires prompt evaluation and treatment.
- Rare diagnoses
- Ankylosing spondylitis: A chronic inflammatory disease that affects the spine and other joints, leading to pain and stiffness. This condition is relatively rare and often requires a thorough evaluation to diagnose.
- Spinal stenosis: A condition where the spinal canal narrows, putting pressure on the nerves and causing pain. This condition is relatively rare and often requires imaging studies to diagnose.
- Osteoporotic compression fracture: A fracture of the vertebrae due to osteoporosis, which can cause severe back pain. This condition is relatively rare in younger individuals but more common in older adults with osteoporosis.