Differential Diagnosis for Neck Pain with Left Arm and Left Hand Numbness

Single Most Likely Diagnosis

• Cervical Radiculopathy: This condition, often due to a herniated disc or cervical spondylosis, compresses or irritates a nerve root in the cervical spine, leading to pain and numbness in the neck and arm. The symptoms described are classic for this diagnosis, particularly if the pain and numbness follow a specific dermatomal pattern.

Other Likely Diagnoses

• Cervical Spondylosis: A common age-related condition that can cause neck pain and radiating symptoms to the arm due to degenerative changes in the cervical spine.
• Thoracic Outlet Syndrome: Compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib) can cause pain and numbness in the neck and arm.
• Herniated Cervical Disc: Similar to cervical radiculopathy, a herniated disc can compress nerves, leading to pain, numbness, and weakness in the arm.

Do Not Miss Diagnoses

• Spinal Cord Compression: Conditions such as spinal stenosis, tumors, or abscesses can compress the spinal cord, leading to severe and potentially irreversible neurological deficits if not promptly addressed.
• Stroke or Transient Ischemic Attack (TIA): Although less common, neck pain can be a symptom of a stroke or TIA, especially if accompanied by other neurological deficits such as weakness, vision changes, or speech difficulties.
• Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including numbness and pain.

Rare Diagnoses

• Pancoast Tumor: A type of lung cancer located at the top of the lung that can invade the brachial plexus, causing arm pain and numbness.
• Brachial Plexitis (Neuralgic Amyotrophy): An inflammatory condition of the brachial plexus that can cause severe pain and weakness in the arm.
• Cervical Spine Infection: Such as osteomyelitis or discitis, which are infections of the bone or disc in the cervical spine, respectively. These conditions can cause severe pain and neurological symptoms.

Each of these diagnoses has a different set of implications for treatment and prognosis, highlighting the importance of a thorough diagnostic evaluation.