Back Pain: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Marfan syndrome – genetic disorder that can be inherited in an autosomal-dominant manner or can be isolated (as a new mutation); systemic connective tissue disorder that is most notable for tall stature, spider-limbedness, and hyperextensibility of the joints; 75% of these patients have an aneurysm (pathologic (abnormal) bulge in the arterial wall)

Respiratory System (J00-J99)

  • Inflammations such as pneumonia (pneumonia).

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Obesity (overweight)

Cardiovascular system (I00-I99)

Liver, gallbladder and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

  • Transfer pain in organ diseases such as diseases of the.
    • Gallbladder – e.g. cholecystitis (inflammation of the gallbladder).
    • Kidneys – e.g. nephrolithiasis (kidney stones).
    • Pancreas (pancreas) – e.g. pancreatitis (pancreatitis), pancreatic cancer (pancreatic cancer).

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Musculoskeletal system and connective tissue (M00-M99).

  • Acute ligament or muscle pain in the spine.
  • Acute irritation condition of the spine
  • Acute reversible joint dysfunction – blockage of a joint that spontaneously recedes.
  • Arthritis (inflammation of the joint) in the spine.
  • Osteoarthritis (joint wear)
  • Autoimmune diseases such as ankylosing spondylitis (ankylosing spondylitis; Latinized Greek: spondylitis “inflammation of the vertebrae” and ankylosans “stiffening”) – chronic inflammatory rheumatic disease with pain and stiffening of joints.
  • Axial spondyloathritis (SpA) – chronic rheumatoid inflammatory systemic disease associated with inflammation in the spine; best known subtype is ankylosing spondylitis (Bekhterev’s disease); first symptoms are deep-seated, often nocturnal back pain and stiffness of the spine; occurrence of the disease usually for the first time in the second to third decade of life
  • Costotransverse joint osteoarthritis (osteoarthritis of the vertebral-rib joints).
  • Coxarthrosis (osteoarthritis of the hip)
  • Disc prolapse (disc prolapse / herniated disc) – at a younger age as a cause of root compression.
  • Disc protrusion (disc protrusion / disc protrusion).
  • Discitis – inflammation of an intervertebral disc.
  • Inflammatory diseases of the spine as in osteomyelitis (inflammation of the bone).
  • Bekhterev’s disease (ankylosing spondylitis; Latinized Greek: spondylitis “inflammation of the vertebrae” and ankylosans “stiffening”) – chronic inflammatory rheumatic disease with pain and stiffening of joints.
  • Scheuermann’s disease (osteochondrosis of the spine) – degenerative changes of bone / cartilage in the area of joints and epiphyses (joint end with bone core), characterized by sclerosis and irregular contouring.
  • Osteomalacia (bone softening) with or without fracture (bone fracture).
  • Osteomyelitis (bone marrow inflammation)
  • Osteoporosis – disease with reduction of bone mass (bone loss) (in older age).
  • Osteophyte formation – degenerative bone attachments.
  • Osteosclerosis – disease with an increase in bone mass but reduced load-bearing capacity.
  • Paget’s disease (synonyms: osteodystrophia deformans, Paget’s disease, Paget’s disease) – disease of the skeletal system in which there is a gradual thickening of several bones, usually the spine, pelvis, extremities or skull.
  • Polymyalgia rheumatica (synonym: polymyalgia) – is a disease belonging to the vasculitides (vascular inflammation) with acute pain of the shoulder and pelvic girdle muscles.
  • Scoliosis – crooked back due to a bent spine.
  • Spina bifida – “open back” due to a defect in embryonic development.
  • Spinal stenosis (spinal stenosis, spinal stenosis) – narrowing of the spinal canal.
  • Spondylodiscitis (inflammation of the intervertebral disc and the two adjacent vertebral bodies), infectious.
  • Spondylolisthesis (spondylolisthesis).
  • Spondylosis – collective term for degenerative changes in vertebral bodies (and intervertebral spaces).

Neoplasms – tumor diseases* (C00-D48).

  • Cervical carcinoma (cervical cancer).
  • Testicular carcinoma (testicular cancer)
  • Renal carcinoma (kidney cancer)
  • Kidney tumors
  • Pancreatic cancer (cancer of the pancreas) – annular back pain without orthopedic cause.
  • Plasmocytoma (multiple myeloma)
  • Skeletal metastases (daughter tumors) – breast carcinoma (breast cancer), prostate carcinoma, bronchial carcinoma (lung cancer), renal cell carcinoma, thyroid carcinoma, Pancreatic carcinoma (cancer of the pancreas), colorectal carcinoma (cancer of the colon), gastric carcinoma, hepatocellular carcinoma, ovarian carcinoma (cancer of the ovary) [listing in decreasing frequency].

Psyche – Nervous System (F00-F99; G00-G99).

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Fracture (fracture of a bone) in the spine.
  • Minor trauma (injury) such as contusion (bruise) or sprain (sprain) of the spine
  • Vertebral fracture

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Postural deformity, misuse, overuse → muscular back pain.

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

Causes (external) of morbidity and mortality (V01-Y84).

  • Physical inactivity
  • One-sided stresses such as sitting for long periods at work
  • Excessive or incorrectly executed sports activity

Medication

  • Α4β7-integrin antagonist (vedolizumab).
  • Glucocorticoids – osteoporotic fractures (fractures caused by bone loss).
  • Opiates – in the withdrawal of opiates.
  • Analgesics (painkillers) – in the withdrawal of analgesics.

Intoxications (poisonings)

Further

  • Stimulation (Simulant)

* When chronic back pain is present, it must be remembered that it is tumor-related if the following tumor diseases are present.