Spinal tuberculosis [top]

  • Progressive onset of back pain or leg weakness chronic back pain
  • Fever is usually absent
  • Elevated inflammatory markers
  • Can lead to psoas abscess
  • Risk factors: Exposure to TB, immunosupression

Spinal tumour [top]

  • Progressive onset of constant back pain over months chronic back pain
  • Progressive neurological deficit affecting legs
  • May be weight loss associated with primary tumour

Spinal abscess [top]

  • Progressive onset of back pain or leg weakness chronic back pain
  • Fever may be present or absent
  • Elevated inflammatory markers
  • Risk factors: Spinal surgery, diabetes, lumbar puncture, epidural

Lumbar disc prolapse [top]

  • Sudden onset of back pain in association with minor trauma such as lifting or coughing acute back pain
  • Large anterior prolapse: Cauda equina syndrome - leg weakness, numbness of perineum, faecal incontinence, urinary retention
  • Posterior prolapse: Shooting pain radiating to thigh, calf 'sciatica'

Spinal stenosis [top]

  • Leg pain, back pain chronic back pain
  • Pain, weakness on prolonged standing
  • History of degenerative spinal disease
  • No features of peripheral vascular disease

Mechanical back pain [top]

  • Acute back pain
  • Back pain and limited movement

Fibroids [top]

  • Menorrhagia
  • Infertility
  • Non-specific symptoms: dyspareunia, painful periods, abdominal bloating, back pain