Differential Diagnosis for Weakness and Pain in Both Shoulders with Intermittent Numbness in Left

• Single Most Likely Diagnosis
  • Cervical Spondylosis: This condition, which involves wear and tear on the discs in the neck, can cause pain and weakness in the shoulders due to compression of the nerves. The intermittent numbness in the left shoulder could be due to radiculopathy affecting the left side more prominently.
• Other Likely Diagnoses
  • Rotator Cuff Tendinitis or Tear: Inflammation or tears in the rotator cuff tendons can cause shoulder pain and weakness. While it might not directly cause numbness, referred pain and secondary muscle imbalances could contribute to numbness.
  • Thoracic Outlet Syndrome: Compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib) can cause pain, weakness, and numbness in the shoulders and arms.
  • Fibromyalgia: A condition characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. While it doesn't typically cause localized numbness, the widespread pain could include the shoulders.
• Do Not Miss Diagnoses
  • Spinal Cord Compression: Conditions like spinal stenosis or a herniated disc in the cervical spine can compress the spinal cord, leading to serious neurological deficits if not promptly addressed. Early symptoms can include pain, weakness, and numbness in the shoulders and arms.
  • Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including numbness, weakness, and pain. Although less common, it's crucial not to miss this diagnosis due to its significant impact on quality of life and the availability of disease-modifying treatments.
• Rare Diagnoses
  • Polymyalgia Rheumatica: An inflammatory disorder that causes muscle pain and stiffness, typically in the shoulders and hips. While it's more common in older adults, it's less likely to cause numbness.
  • Neoplastic Processes: Tumors, either primary in the shoulder region or metastatic, could cause pain and weakness. Numbness would be less common unless the tumor compresses nearby nerves.
  • Infectious or Inflammatory Arthropathies: Conditions like septic arthritis or rheumatoid arthritis can cause shoulder pain and weakness. Numbness is less typical unless there's significant swelling or inflammation compressing nerves.