Differential Diagnosis for Head Pain Radiating to Shoulder
- Single Most Likely Diagnosis
- Tension headache: This is the most common type of headache and often presents with pain radiating from the head to the neck and shoulders due to muscle tension.
- Other Likely Diagnoses
- Cervicogenic headache: This type of headache is caused by referred pain from the cervical spine and can radiate to the shoulder and arm.
- Migraine: Although typically associated with unilateral head pain, migraines can sometimes cause pain to radiate to the shoulder, especially if there is significant neck involvement.
- Temporomandibular joint (TMJ) disorder: Pain from the TMJ can radiate to the head, neck, and shoulders, especially with jaw movement or clenching.
- Do Not Miss Diagnoses
- Subarachnoid hemorrhage: Although less common, a sudden, severe headache (often described as "the worst headache of my life") that could potentially radiate to the shoulder due to meningeal irritation is a medical emergency.
- Giant cell arteritis: This condition can cause headache and pain in the temples, which might radiate to the shoulder, and is a medical emergency due to the risk of vision loss.
- Cervical spine fracture or instability: Trauma to the cervical spine can cause pain radiating to the shoulder and is critical to diagnose to prevent further injury.
- Rare Diagnoses
- Occipital neuralgia: Inflammation of the occipital nerves can cause sharp, stabbing pain in the head that might radiate to the shoulder.
- Referred pain from thoracic or abdominal pathology: Rarely, conditions such as a myocardial infarction (heart attack) or abdominal emergencies like a ruptured aneurysm can cause referred pain to the shoulder and head, although this would typically be accompanied by other significant symptoms.