Differential Diagnosis for Unable to Raise Arm Overhead and Reaching Over Back
- Single Most Likely Diagnosis
- Adhesive Capsulitis (Frozen Shoulder): This condition is characterized by stiffness and pain in the shoulder joint, making it difficult to move the arm, especially in overhead movements. It is a common cause of limited shoulder mobility and matches the symptoms described.
- Other Likely Diagnoses
- Rotator Cuff Tendinitis or Tear: Inflammation or tears in the rotator cuff tendons can cause pain and weakness in the shoulder, limiting the ability to raise the arm overhead.
- Shoulder Impingement Syndrome: This condition occurs when the shoulder blade puts pressure on the underlying soft tissues, including the rotator cuff tendons, when the arm is raised, causing pain and limiting movement.
- Bursitis: Inflammation of the bursae in the shoulder can cause pain and stiffness, especially when moving the arm overhead.
- Do Not Miss Diagnoses
- Thoracic Outlet Syndrome: A condition where the nerves and/or blood vessels are compressed between the collarbone and first rib, leading to pain, numbness, and weakness in the arm. While less common, missing this diagnosis could lead to significant morbidity.
- Cervical Radiculopathy: Compression or irritation of the nerves in the cervical spine can cause pain, numbness, and weakness in the arm, including limitations in movement.
- Pancoast Tumor: A type of lung cancer located at the top of the lung that can compress nerves and other structures, leading to shoulder pain and limited mobility. Although rare, it is critical not to miss this diagnosis due to its severe implications.
- Rare Diagnoses
- Polymyalgia Rheumatica: An inflammatory condition that causes muscle pain and stiffness, particularly in the shoulders, but is less directly associated with the specific limitation of raising the arm overhead.
- Osteonecrosis of the Humeral Head: A condition where the bone tissue of the humeral head dies due to lack of blood supply, leading to shoulder pain and limited mobility. It is less common and might not be the first consideration but should be kept in mind, especially in patients with risk factors.