Differential Diagnosis for Right Non-Radiating Neck Pain with Headaches
Single Most Likely Diagnosis
- Mechanical Neck Pain: This is the most common cause of neck pain and is often associated with headaches. The fact that the pain is non-radiating and the patient is afebrile supports this diagnosis, as it suggests a musculoskeletal origin rather than a neurological or infectious one.
Other Likely Diagnoses
- Cervicogenic Headache: These headaches are referred from the cervical spine and can cause neck pain and headaches without fever. The non-radiating nature of the neck pain could be consistent with this diagnosis.
- Tension Headache: Often presents with neck pain and headache, and the absence of fever and radiation of pain makes this a plausible diagnosis.
- Degenerative Disc Disease: Can cause chronic neck pain and headaches, especially if there is associated cervical spine degeneration.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less likely given the chronic nature of the symptoms and the absence of fever, a sudden onset of severe headache (often described as "the worst headache of my life") could be indicative of a subarachnoid hemorrhage. The fact that the current symptoms are not severe does not entirely rule out the possibility of a previous, smaller bleed or an impending larger event.
- Meningitis: Typically presents with fever, headache, and stiff neck, but early in the course, fever might be absent. Given the potential severity, it's crucial to consider, even though the patient is currently afebrile.
- Cervical Spine Fracture: Especially if there was a traumatic event, even a minor one, that the patient might not consider significant. The absence of radiation does not rule out a fracture.
Rare Diagnoses
- Cervical Dystonia: A neurological disorder that can cause neck pain and abnormal postures of the neck, potentially leading to headaches.
- Neck Pain due to Vascular Causes: Such as vertebral artery dissection, which can cause neck pain and headache, often without fever.
- Inflammatory Arthritis: Conditions like rheumatoid arthritis or psoriatic arthritis can cause neck pain and stiffness, though they typically have other systemic symptoms or signs of inflammation.