Differential Diagnosis for Neck Pain Radiating to Scapular Region
Single Most Likely Diagnosis
- Cervical Spondylosis or Cervical Disc Herniation: This condition is a common cause of neck pain that radiates to the scapular region, especially in middle-aged individuals. The pain worsening in the morning could be due to the accumulation of inflammatory substances during sleep or decreased disc height, which can irritate nerves.
Other Likely Diagnoses
- Musculoskeletal Strain: Morning stiffness and pain could be indicative of a musculoskeletal issue, such as a strain from overuse or poor posture, which is common and can cause referred pain to the scapular region.
- Thoracic Outlet Syndrome: 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), which can cause pain in the neck and shoulder region that radiates to the scapular area.
- Scalene Muscle Spasm: Tightness or spasm in the scalene muscles can refer pain to the neck and scapular region, especially if there's an element of poor posture or repetitive strain.
Do Not Miss Diagnoses
- Cervical Spinal Stenosis: Although less common, this condition can cause significant pain and neurological symptoms. It's crucial to identify as it may require urgent surgical intervention to prevent further neurological deterioration.
- Pancoast Tumor: A type of lung cancer located at the top of the lung, which can cause shoulder and neck pain due to invasion of the brachial plexus and adjacent structures. Early detection is critical for treatment.
- Infectious or Inflammatory Conditions (e.g., Discitis, Osteomyelitis): These conditions, although rare, can present with severe pain and morning stiffness. They require prompt diagnosis and treatment to prevent serious complications.
Rare Diagnoses
- Referred Pain from Visceral Sources: Rarely, pain from abdominal or thoracic organs can refer to the neck and scapular region. Conditions such as gallbladder disease or pancreatic disorders could potentially cause such referred pain, though this would be unusual.
- Neurological Conditions (e.g., Multiple Sclerosis, Peripheral Neuropathy): While these conditions can cause a wide range of neurological symptoms, they are less likely to present solely with neck pain radiating to the scapular region without other neurological signs.