Differential Diagnosis for Posterior Shoulder Pain
- Single most likely diagnosis
- Rotator cuff tendinopathy or strain: This is the most common cause of posterior shoulder pain, often resulting from overuse or repetitive strain on the rotator cuff muscles and tendons.
- Other Likely diagnoses
- Scapulothoracic bursitis: Inflammation of the bursa between the scapula and thoracic wall can cause posterior shoulder pain, especially with movements that involve scapular rotation.
- Thoracic outlet syndrome: Compression of the nerves and blood vessels between the thoracic outlet can cause pain in the posterior shoulder region, often accompanied by numbness, tingling, or weakness in the arm.
- Levator scapulae strain: The levator scapulae muscle runs from the neck to the scapula, and strain or overuse of this muscle can cause posterior shoulder pain, especially with movements that involve scapular elevation.
- Do Not Miss diagnoses
- Pulmonary embolism: Although rare, a pulmonary embolism can cause sudden onset of posterior shoulder pain, often accompanied by shortness of breath, chest pain, or cough.
- Pneumothorax: A collapsed lung can cause sharp, stabbing posterior shoulder pain, often accompanied by shortness of breath or chest pain.
- Myocardial infarction (MI): In some cases, an MI can cause referred pain to the posterior shoulder region, especially if the inferior wall of the heart is involved.
- Rare diagnoses
- Pancoast tumor: A rare type of lung cancer that can cause posterior shoulder pain, often accompanied by weight loss, cough, or shortness of breath.
- Brachial plexitis (neuralgic amyotrophy): A rare condition characterized by inflammation of the brachial plexus, causing severe posterior shoulder pain, often accompanied by weakness or numbness in the arm.
- Osteoid osteoma: A rare benign bone tumor that can cause posterior shoulder pain, often accompanied by pain at night or with activity.