Differential Diagnosis for Right Sided Burning Neck Pain into Shoulder Blade

• Single Most Likely Diagnosis
  • Cervical Spondylosis or Cervical Disc Herniation: This condition is a common cause of neck pain that can radiate to the shoulder blade due to compression or irritation of the cervical nerve roots. The burning nature of the pain suggests involvement of the nerve roots.
• Other Likely Diagnoses
  • Thoracic Outlet Syndrome (TOS): This condition involves compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib). It can cause neck and shoulder pain, including a burning sensation, and can radiate to the shoulder blade.
  • Myofascial Pain Syndrome: This is a condition characterized by pain and inflammation in the muscles and their surrounding soft tissues. It can cause localized or referred pain, including to the neck and shoulder area, often described as burning.
  • Costochondritis or Tietze's Syndrome: Inflammation of the cartilage that connects the ribs to the breastbone can cause chest pain but also refer pain to the neck and shoulder area, potentially feeling like a burning sensation.
• Do Not Miss Diagnoses
  • Pulmonary Embolism: Although less common, a pulmonary embolism can cause sudden onset of chest pain that may radiate to the neck and shoulder. The pain can be sharp or burning and is often accompanied by shortness of breath.
  • Aortic Dissection: A tear in the inner layer of the aorta can cause severe, tearing chest pain that can radiate to the back, neck, or shoulder. It's a medical emergency.
  • Spinal Cord Compression or Cauda Equina Syndrome: These conditions involve compression of the spinal cord or the nerves in the lower spine and can cause a variety of symptoms, including pain, numbness, and weakness. While the primary symptoms might not be limited to neck and shoulder pain, they are critical to diagnose early.
• Rare Diagnoses
  • Pancoast Tumor: A type of lung cancer located at the top of the lung that can cause shoulder and neck pain due to invasion of the brachial plexus or nearby structures. The pain can be severe and burning.
  • Referred Pain from Abdominal Pathologies: Certain abdominal conditions, like gallbladder disease or pancreatitis, can refer pain to the right shoulder or neck, though this is less common and usually accompanied by other symptoms like abdominal pain or jaundice.
  • Complex Regional Pain Syndrome (CRPS): A chronic pain condition characterized by severe, burning pain at the site of an injury, which can sometimes be referred to the neck and shoulder area, though it typically involves an arm or leg.