Differential Diagnosis of Lower Back Pain

Low back pain is pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, with or without sciatica, and is defined as chronic when it persists for 12 weeks or more.

Incidence and Prevalence About 25% of American adult sreports to have a lower back pain lasting in a whole day. 7.6% of the adults report to have had at least 1 episode of severe lower back pain. Lower Back Pain is estimated at 60% to 70% prevalence in industrialized countries. The prevalence rate is lower in children and adolescents compared to that of adults.

Pathophysiology There are many causes of low back pain some resulting to a migrant and severe pain. Infections such as the pelvic inflammatory disease in women’s reproductive organs causes back pain during urination or sex. Also, a slipped disc on the spine from the neck to the lower back is a common cause of the low back pain. The major cause of the low back pain among the American adults is overweight and lack of enough exercises. Also, old age has been found to be a reason why low back pain affects most American adults.

Clinical Presentation- Prodromal Symptoms Gradual increase of pain to a point where a person begins to feel sharp pain in the lower back especially during sports or lifting weights. Loss of bowel or bladder control, numbness in the groin, weakened legs, fever and pain when a person is coughing or urinating. If not managed, lower back pain decreases physical performance and increases depression symptoms especially to the elderly adults.

Differential Diagnosis and Rule Out

• Diagnosis : back strain as pain increases with bending and activity.
• Acute disc herniation: r/o by absence of pain in lower leg
• Osteoarthritis: r/o by absence of sharp shooting pain and parasthesia in leg
• Spondylolisthesis: r/o by absence of tight…