Low Back Pain (Lumbago) - Common Differential Diagnosis ...

Low Back Pain (Lumbago) - Common Differential Diagnosis and Patterns

Mechanical Low Back Pain:

Aching pain in the lumbosacral area; may radiate into lower leg, especially along L5 (lateral leg) or S1 (posterior leg) dermatomes. Refers to anatomic or functional abnormality in absence of neoplastic, infectious, or inflammatory disease. Usually acute (<3 months), idiopathic, benign, and self-limiting; 

represents 97% of symptomatic low back pain. Commonly work related and occurring in patients 30 to 50 years. Risk factors include heavy lifting, poor conditioning, obesity. 

Sciatica (Radicular Low Back Pain):

Shooting pain below the knee, commonly into the lateral leg (L5) or posterior calf (S1) typically accompanies low back pain.  Patients report associated paresthesias and weakness. Bending, sneezing, coughing, straining during bowel movements often worsen pain.

Lumbar Spinal Stenosis:

"Pseudoclaudication" pain in the back or legs with walking that improves with rest, lumbar flexion (which decompresses spinal cord), or both. Pain vague but usually bilateral, with paresthesias in one or both legs. 

Chronic Back Stiffness 

Nocturnal Back Pain, Unrelieved by Rest

Pain Referred from the Abdomen or Pelvis:

Usually a deep, aching pain; the level varies with the source. Accounts for —2% of low back pain. 

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