Differential Diagnosis for Unilateral Upper Back Muscular Pain
- Single most likely diagnosis
- Muscular strain: This is the most common cause of unilateral upper back pain, often resulting from overuse, poor posture, or direct trauma to the muscles.
- Other Likely diagnoses
- Thoracic outlet syndrome: Compression of the nerves and/or blood vessels between the clavicle and first rib can cause pain in the upper back, often unilateral.
- Scoliosis: Abnormal curvature of the spine can lead to uneven muscle strain, resulting in unilateral upper back pain.
- Rib fracture: A fracture of one of the ribs can cause severe, localized pain in the upper back.
- Myofascial pain syndrome: Irritation of the muscles and their surrounding connective tissue can cause pain, often unilateral, in the upper back.
- Do Not Miss diagnoses
- Pulmonary embolism: Although less common, a pulmonary embolism can cause sudden, severe chest pain that may radiate to the upper back, and is a medical emergency.
- Pneumothorax: A collapsed lung can cause sudden, severe chest pain that may radiate to the upper back, and requires immediate medical attention.
- Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine can cause severe, localized pain, and if left untreated, can lead to serious complications.
- Pancoast tumor: A type of lung cancer that can cause shoulder and upper back pain due to compression of nearby nerves.
- Rare diagnoses
- Multiple myeloma: A type of blood cancer that can cause bone pain, including in the upper back.
- Osteoporotic compression fracture: A fracture of a vertebra due to osteoporosis can cause sudden, severe back pain.
- Spinal cord tumor: A tumor in the spinal cord can cause pain, numbness, and weakness, and requires prompt medical attention.