Differential Diagnosis for Neck Pain and Stiffness with Posterior Headache in a Smoker
- Single Most Likely Diagnosis
- Cervical Spondylosis: This condition is a common cause of neck pain and stiffness, especially in smokers due to decreased blood flow and increased inflammation. The posterior headache can be referred pain from the cervical spine.
- Other Likely Diagnoses
- Cervical Strain: Muscle strain in the neck can cause pain and stiffness, and is often associated with poor posture or trauma. Smoking can exacerbate muscle strain due to decreased blood flow and oxygenation.
- Tension Headache: Tension headaches can cause neck pain and stiffness, as well as posterior headache. Smoking can trigger or worsen tension headaches.
- Herniated Cervical Disc: A herniated disc in the cervical spine can cause neck pain, stiffness, and radiating pain, including posterior headache.
- Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less likely, a subarachnoid hemorrhage can present with sudden onset of severe headache and neck stiffness. Smoking is a risk factor for aneurysms, which can rupture and cause a subarachnoid hemorrhage.
- Meningitis: Meningitis is an infection of the meninges that can cause neck stiffness, headache, and fever. While less common, it is a potentially life-threatening condition that requires prompt diagnosis and treatment.
- Cervical Spine Fracture: A fracture of the cervical spine can cause neck pain and stiffness, and is especially concerning in smokers who may have osteoporosis or decreased bone density.
- Rare Diagnoses
- Rheumatoid Arthritis: Although less common, rheumatoid arthritis can cause neck pain and stiffness, especially in the cervical spine. Smoking is a risk factor for developing rheumatoid arthritis.
- Multiple Myeloma: Multiple myeloma is a type of cancer that can cause bone pain, including neck pain and stiffness. Smoking is a risk factor for developing multiple myeloma.
- Cervical Spine Infection: Infections such as osteomyelitis or discitis can cause neck pain and stiffness, and are more common in smokers due to decreased immune function.