Back pain onset over years

CLINICAL DIAGNOSTIC MANUAL

Back pain that has progressed over the years is often associated with structural deformities of the spine, chronic neurological diseases, or postural abnormalities. Conditions such as scoliosis or complications from diseases like syringomyelia tend to develop slowly, causing postural changes and alterations in the biomechanics of the spine. The pain can become chronic, affecting quality of life and limiting mobility. Proper evaluation through imaging and neurological studies is crucial to identify the underlying cause.

Pathology	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Kyphotic pain	Back pain with abnormal forward curvature (kyphosis), stiffness, limited movement, visible spinal deformity.	Kyphotic curvature in the thoracic spine, pain with stiffness.	Spinal X-ray showing abnormal curvature (kyphosis).
Scoliotic pain	Back pain, visible deformity, shoulder or hip asymmetry.	Lateral spinal deviation with progressive pain.	Spinal X-ray showing lateral deviation of the spine (scoliosis).
Poliomyelitis	Chronic back pain, progressive muscle weakness, muscle atrophy, fatigue.	History of poliovirus infection and development of muscle weakness and pain over time.	Electromyography showing muscle weakness and peripheral nerve damage.
Syringomyelia	Back pain, loss of pain and temperature sensation, progressive muscle weakness, neurological symptoms.	Dissociated sensory loss and progressive limb weakness, with back pain.	MRI showing the cyst (syrinx) in the spinal cord.
Idiopathic scoliosis	Mild to moderate back pain, visible deformity, slow progression of spinal deviation.	Lateral spinal deviation, usually diagnosed in adolescence.	Spinal X-ray confirming scoliosis and its severity.