Differential Diagnosis for Neck Pain, Headache, and Eye Pain in a 24-Year-Old Female

Single Most Likely Diagnosis

• Tension Headache: This is the most common type of headache and can be associated with neck pain and eye strain. It is often related to stress, poor posture, or muscle tension.

Other Likely Diagnoses

• Migraine: Migraines can cause severe headaches, often accompanied by sensitivity to light and sound, and may involve neck pain and eye discomfort.
• Cervicogenic Headache: This type of headache originates from the cervical spine and can cause pain on one side of the head, including the eye, and is often accompanied by neck pain.
• Sinusitis: Inflammation of the sinuses can cause pain in the face, including the eyes, and can radiate to the neck, accompanied by headache.

Do Not Miss Diagnoses

• Subarachnoid Hemorrhage: Although rare, this condition is life-threatening and can present with sudden, severe headache, neck stiffness, and sometimes eye pain due to increased intracranial pressure.
• Meningitis: Infection of the meninges can cause severe headache, neck stiffness, and sensitivity to light, which could be perceived as eye pain.
• Temporal Arteritis: This condition involves inflammation of the blood vessels and can cause headache, jaw pain, and visual disturbances, including eye pain.

Rare Diagnoses

• Occipital Neuralgia: Involves inflammation of the occipital nerves and can cause severe pain in the neck and back of the head, sometimes extending to the eye.
• Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, which can cause intense pain in parts of the face, including the eyes.
• Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues, which can lead to musculoskeletal pain, including neck and headache, due to joint hypermobility and tissue fragility.

Each of these diagnoses has a different set of implications for treatment and management, emphasizing the importance of a thorough diagnostic evaluation to determine the underlying cause of the symptoms.