A Common Complaint With an Uncommon Etiology: A Case Report of Back Pain Caused by Paravertebral Compartment Syndrome.

Background: Patients presenting with acute low back pain (LBP) require prompt evaluation, diagnosis, and management to prevent permanent complications. Up to 10% to 15% of patients with LBP have been shown to display neurologic deficits that could lead to downstream complications, such as lower extremity paralysis, numbness, and neurogenic bowel and bladder.

Case report: The authors present a 44-year-old man who arrived at our emergency room after a drug overdose. He endorsed severe left-sided back pain, a heavy sensation in his bilateral lower extremities, and complete loss of motor and sensory ability from the waist down. Imaging of his thoracic and lumbar spine revealed diffuse edema and expansion of the left paraspinal muscles with postcontrast enhancement, concerning for acute compartment syndrome.

Conclusions: Compartment syndrome of the paraspinal muscles is an extremely rare condition. However, paravertebral compartment syndrome must remain on the differential for practitioners who are presented with acute back pain.