Differential Diagnosis for Arm Numbness and Shoulder Pain
Single Most Likely Diagnosis
- Cervical Radiculopathy: This condition, often caused by a herniated disk or bone spur in the cervical spine, can lead to numbness in the arms, sharp pain in the shoulder, and worsening symptoms with movement. The distribution of numbness from the shoulder down and the exacerbation of pain with movement are consistent with nerve root irritation.
Other Likely Diagnoses
- Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass through the thoracic outlet (the space between the collarbone and first rib). It can cause numbness in the arms, shoulder pain, and worsening symptoms with movement, especially if the compression is exacerbated by certain positions or activities.
- Rotator Cuff Tendinitis or Tear: While primarily causing shoulder pain, severe cases can lead to referred pain and numbness down the arm, especially if there is associated inflammation or swelling that irritates nearby nerves.
- Brachial Plexus Injury: Trauma to the brachial plexus, a network of nerves that conducts signals from the spinal cord to the shoulder, arm, and hand, can result in numbness, pain, and weakness in the arm, with symptoms worsening with movement.
Do Not Miss Diagnoses
- Cervical Spinal Cord Compression: Conditions such as spinal stenosis, herniated disks, or tumors can compress the spinal cord, leading to numbness, pain, and potentially severe neurological deficits. Early recognition is crucial to prevent permanent damage.
- Myocardial Infarction (Heart Attack): Although less common, cardiac conditions can refer pain to the shoulder and arm. A heart attack can present with arm numbness or pain, especially if the individual has diabetes or other conditions that affect nerve sensation.
- Pulmonary Embolism: In rare cases, a pulmonary embolism can cause referred pain to the shoulder and arm due to irritation of the nerves in the lung or chest wall.
Rare Diagnoses
- Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including numbness and pain in the arms.
- Peripheral Neuropathy: Conditions such as diabetes, vitamin deficiencies, or autoimmune disorders can cause damage to the peripheral nerves, leading to numbness, pain, and weakness in the arms.
- Tumors: Both benign and malignant tumors can compress nerves, leading to numbness and pain. These could be located in the spine, shoulder, or arm itself.