Differential Diagnosis for Nerve Pain from Neck to T9
- Single most likely diagnosis
- Cervicothoracic radiculopathy or thoracic outlet syndrome: This condition involves compression or irritation of the nerves that originate in the cervical or thoracic spine, which can cause pain radiating from the neck down to the upper back, consistent with the described symptoms.
- Other Likely diagnoses
- Thoracic disc herniation: A herniated disc in the thoracic spine can compress or irritate nearby nerves, leading to pain that radiates along the nerve's path, potentially from the neck down to the level of T9.
- Costochondritis or Tietze's syndrome: Inflammation of the cartilage that connects the ribs to the breastbone can cause chest pain that may radiate to the back, potentially mimicking the described pain pattern.
- Myofascial pain syndrome: This condition involves pain and inflammation in the muscles and their surrounding connective tissue, which could cause referred pain patterns that might fit the description.
- Do Not Miss diagnoses
- Pulmonary embolism: Although less likely to cause nerve pain in a dermatomal pattern, a pulmonary embolism can cause sudden, severe chest or back pain and is a life-threatening condition that must be ruled out.
- Aortic dissection: This is a serious condition where there is a tear in the aorta's inner layer, which can cause severe, tearing chest or back pain that may radiate, and is immediately life-threatening.
- Spinal cord compression or tumor: Compression of the spinal cord due to a tumor or other lesion can cause a range of neurological symptoms, including pain, and is critical to diagnose early.
- Rare diagnoses
- 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 that might radiate down the back.
- Notalgia paresthetica: A condition characterized by itching, burning, or tingling on the skin of the upper back, which might be perceived as nerve pain, though it's more superficial and typically not as severe as radiculopathy.
- Spondylosis or spondylolisthesis: Although more common in the lumbar spine, these conditions (degeneration of the spine or slippage of one vertebra over another) can occur in the thoracic spine and cause nerve compression or irritation.