Differential Diagnosis for Radiating Pain to Neck and Shoulder

• Single most likely diagnosis:
  • Cervical Spondylosis: This condition, which involves wear and tear on the discs in the neck, can cause radiating pain to the neck and shoulder due to compression or irritation of the nerves.
• Other Likely diagnoses:
  • Herniated Cervical Disc: A herniated disc in the cervical spine can compress nerves, leading to pain that radiates to the neck and shoulder.
  • Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib), leading to pain in the neck and shoulder.
  • Rotator Cuff Tendinitis: Inflammation of the tendons in the shoulder joint can cause pain that radiates to the neck and shoulder area.
• Do Not Miss diagnoses:
  • Myocardial Infarction (Heart Attack): Although less common, myocardial infarction can present with referred pain to the neck and shoulder, making it crucial not to miss this potentially life-threatening condition.
  • Pulmonary Embolism: In some cases, a pulmonary embolism can cause sudden onset of chest pain that radiates to the neck and shoulder.
• Rare diagnoses:
  • Pancoast Tumor: A rare type of lung cancer located at the top of the lung, which can cause shoulder and neck pain due to invasion of the brachial plexus.
  • Multiple Myeloma: A type of blood cancer that can cause bone pain, including in the neck and shoulder area, although this would typically be accompanied by other systemic symptoms.
  • Rheumatologic Conditions (e.g., Polymyalgia Rheumatica): These conditions can cause widespread musculoskeletal pain, including in the neck and shoulder, but are less common causes of radiating pain.