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Differential Diagnosis for Left Sided Shoulder and Upper Trapezius Pain, Numbness

  • Single Most Likely Diagnosis
    • Cervical Radiculopathy: This condition, often resulting from a herniated disc or bone spur in the cervical spine, can cause pain and numbness in the shoulder and upper trapezius area due to compression of the nerve roots. The symptoms can radiate down from the neck to the shoulder and arm, matching the described pain and numbness.
  • Other Likely Diagnoses
    • Thoracic Outlet Syndrome (TOS): TOS involves compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the thoracic outlet area, which lies between your collarbone (clavicle) and first rib. This can lead to pain in the shoulders and neck and numbness in the fingers.
    • Myofascial Pain Syndrome: This condition is characterized by muscle pain and stiffness, often caused by trigger points within the muscles. The upper trapezius is a common site for myofascial pain, which can cause localized pain and referred pain patterns, including to the shoulder area.
    • Rotator Cuff Tendinitis or Tear: While primarily causing shoulder pain, severe cases of rotator cuff injuries can refer pain to the upper trapezius area due to compensatory muscle use and inflammation.
  • Do Not Miss Diagnoses
    • Cervical Spinal Stenosis: A narrowing of the spinal canal in the neck, which can put pressure on the spinal cord, potentially leading to serious neurological symptoms if not addressed promptly.
    • Pancoast Tumor: A type of lung cancer located at the top of the lung that can invade nearby structures, including nerves, causing shoulder and arm pain, and numbness.
    • Vertebral Artery Dissection: A tear in the vertebral artery, which can lead to a stroke if not recognized and treated immediately.
  • Rare Diagnoses
    • Brachial Plexitis (Neuralgic Amyotrophy): An inflammatory condition affecting the nerves of the brachial plexus, leading to severe pain, usually in the shoulder and upper arm, followed by weakness and atrophy of the muscles.
    • Apical Lung Tumor (other than Pancoast tumor): Although less common, other types of lung tumors can cause referred pain to the shoulder and upper trapezius area through various mechanisms, including nerve invasion or compression.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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