Differential Diagnosis for Severe Back and Neck Pain with Nasal Pressure
Single Most Likely Diagnosis
- Musculoskeletal Strain or Sprain: This is often the most common cause of severe back and neck pain, which can also refer pain to other areas due to muscle tension, potentially causing nasal pressure due to referred pain or tension in the neck and face muscles.
Other Likely Diagnoses
- Tension Headache: Can cause severe pain in the neck and back due to muscle tension, and may also cause nasal pressure due to the involvement of facial muscles.
- Sinusitis: Inflammation of the sinuses can cause nasal pressure and pain, which may radiate to the neck and back due to the referral of pain through the trigeminal nerve.
- Cervicogenic Headache: Originates from the cervical spine and can cause pain in the neck, back, and head, including nasal pressure due to the distribution of the cervical nerves.
Do Not Miss Diagnoses
- Meningitis: Although less likely, meningitis is a life-threatening condition that can cause severe back and neck pain (due to irritation of the meninges) and nasal pressure (due to increased intracranial pressure), making it crucial not to miss.
- Subarachnoid Hemorrhage: A severe headache with sudden onset, potentially accompanied by neck stiffness and pain, which could also cause nasal pressure due to increased intracranial pressure.
- Spinal Epidural Abscess: A serious condition that can cause severe back and neck pain, and if the abscess compresses nerves, it could potentially cause referred pain that might be perceived as nasal pressure.
Rare Diagnoses
- Temporal Arteritis: An inflammation of the blood vessels in the head, which can cause severe headaches, jaw pain, and potentially nasal pressure due to the involvement of the facial arteries.
- Occipital Neuralgia: Involves the nerves that run from the neck to the back of the head and can cause severe pain in these areas, potentially radiating to the face and causing nasal pressure.
- Rheumatologic Diseases (e.g., Rheumatoid Arthritis, Ankylosing Spondylitis): These conditions can cause widespread musculoskeletal pain, including back and neck pain, and in some cases, may involve the facial structures, leading to nasal pressure.