Differential Diagnosis for Bilateral Arm Pain Worse at Night
- Single most likely diagnosis
- Cervical Spondylosis: This condition is a common cause of bilateral arm pain, especially in older adults. The pain often worsens at night due to prolonged periods of rest, which can exacerbate the underlying degenerative changes in the cervical spine.
- Other Likely diagnoses
- Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass through the thoracic outlet, leading to pain, numbness, and tingling in the arms. Symptoms can worsen at night, especially if the patient sleeps with their arms in a position that exacerbates the compression.
- Fibromyalgia: This chronic condition is characterized by widespread muscle pain, fatigue, and sleep disturbances. Bilateral arm pain that worsens at night is a common symptom, possibly due to poor sleep quality and increased muscle tension.
- Repetitive Strain Injury: This condition occurs when the muscles and tendons in the arms are overused or strained, leading to pain and inflammation. Symptoms can worsen at night, especially if the patient engages in activities that exacerbate the condition during the day.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pancoast Tumor: This rare type of lung cancer can cause bilateral arm pain by compressing the nerves that run from the spine to the arms. Although it is a rare condition, it is essential to consider it in the differential diagnosis due to its potential for severe consequences if left untreated.
- Spinal Cord Compression: This condition occurs when the spinal cord is compressed, often due to a tumor, herniated disk, or other lesion. Bilateral arm pain that worsens at night can be a symptom, and prompt diagnosis and treatment are crucial to prevent permanent damage.
- Multiple Myeloma: This type of blood cancer can cause bone pain, including bilateral arm pain, due to the proliferation of malignant plasma cells in the bone marrow. Although it is a rare condition, it is essential to consider it in the differential diagnosis due to its potential for severe consequences if left untreated.
- Rare diagnoses
- Complex Regional Pain Syndrome: This chronic condition is characterized by severe, burning pain in one or more limbs, often after an injury or trauma. Bilateral arm pain that worsens at night is a possible symptom, although it is a rare condition.
- Brachial Plexitis: This condition involves inflammation of the brachial plexus, a network of nerves that run from the spine to the arms. Bilateral arm pain that worsens at night can be a symptom, although it is a rare condition.
- Amyloidosis: This group of diseases is characterized by the deposition of abnormal proteins (amyloid) in various tissues, including the nerves. Bilateral arm pain that worsens at night is a possible symptom, although it is a rare condition.