Low back pain differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Diagnosing the cause of back pain can be difficult, because many diseases can cause this symptom. Most frequently the cause is benign and/or self-limiting, but more serious causes may require urgent intervention. Acute back pain is a severe, persistent back pain of sudden onset that is likely to require surgical intervention to treat its cause. The following table summarizes differential diagnosis for back pain.

Differential Diagnosis of Back Pain

Classification of pain in the back based on etiology	Diease	Clinical Manifestation		Diagnosis		Comments
		Symptoms	Signs	Lab findings	Imaging
Vascular	Aortic dissection
	Aortic aneurysm - Abdominal aneurysm - Thoracic aneurysm
Neurological	Spinal cord compression - Thoracic spine - Lumbar spine
	Cauda equina compression
	Radiculopathy
	Epidural abscess
Bone	Discitis
	Vertebral osteomyelitis
	Septic sacroilitis
	Vertebral compression fracture
	Spinal stenosis
	Osteoarthritis
	Ankylosing spondylitis
	Scoliosis
	Hyperkyphosis
	Spondylosis - Spondylolisthesis
	Scheuermann (juvenile) kyphosis
	Disc herniation
	Sacroiliac joint dysfunction
	Bertolotti's syndrome (Lumbosacral transitional vertebrae)
Non-spinal infections	Pyomyositis
	Pyelonephritis
	Pneumonia
	Pelvic inflammatory disease
	Endocarditis
	Myalgia
Tumors	Bone tumors - Osteoid osteoma - Osteoblastoma - Ewing sarcoma - Osteosarcoma
	Other tumors - Lymphoma - Prostate cancer - Neurofibroma - Leukemia - Langerhan cell histocytosis (eosinophilic granulomas)
Muscle-related
Miscellaneous