Differential Diagnosis for Pain in Left Back of Head, Left Side of Neck, and Left Arm with Elevated Blood Pressure

Single Most Likely Diagnosis

• Cervical Spondylosis or Cervical Radiculopathy: This condition is characterized by wear and tear on the discs in the neck, which can cause pain in the neck, head, and arm due to nerve compression. The elevated blood pressure could be coincidental or related to pain-induced stress.

Other Likely Diagnoses

• Tension Headache: Often presents with neck pain and can radiate to the arm, possibly exacerbated by or contributing to elevated blood pressure due to stress or anxiety.
• Thoracic Outlet Syndrome: 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 arm. Elevated blood pressure might not be directly related but could be a comorbidity.
• Musculoskeletal Strain: Could result from overuse or injury, leading to pain in the neck, head, and arm. The elevated blood pressure might be unrelated or a response to pain.

Do Not Miss Diagnoses

• Subarachnoid Hemorrhage or Other Intracranial Hemorrhages: Although less likely, these are emergencies that can present with sudden onset headache and elevated blood pressure. The pain could radiate to the neck and arm.
• Stroke or Transient Ischemic Attack (TIA): Can cause sudden onset of headache, neck pain, and arm pain, especially if the stroke affects the brainstem or cervical spinal cord. Elevated blood pressure is a risk factor for stroke.
• Temporal Arteritis: An inflammation of the blood vessels in the head, which can cause headache, jaw pain, and visual disturbances. While arm pain is less common, it's a condition that requires prompt treatment to prevent complications like blindness.

Rare Diagnoses

• Cervical Artery Dissection: A tear in one of the arteries in the neck, which can lead to stroke or other neurological symptoms, including pain in the head, neck, and arm.
• Pancoast Tumor: A type of lung cancer located at the top of the lung that can cause shoulder and arm pain due to invasion of the brachial plexus, along with headache and neck pain if it spreads to nearby structures.
• Referred Pain from Cardiac Sources: Such as coronary artery disease, which can cause arm pain and is associated with elevated blood pressure as a risk factor. However, the headache and neck pain would be less typical presentations.