Neck pain differential diagnosis
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Overview
There is extensive differential diagnosis for neck pain.Varity of diseases manifest as neck pain.The most causes are biomechanical axial neck pain, whiplash associated disorder (WAD),radiculopathy, cervical myelopathy, infection, neoplasm, rheumatic causes, trauma, referred pain and fibromyalgia.
Differentiating neck pain from other Diseases
There is extensive differential diagnosis for neck pain.Varity of diseases manifest as neck pain.The most causes are biomechanical axial neck pain, whiplash associated disorder (WAD),radiculopathy, cervical myelopathy, infection, neoplasm, rheumatic causes, trauma, referred pain and fibromyalgia.[1]
Differentiating neck pain from other diseases
| Diseases | symptoms | physical examination | |
|---|---|---|---|
| Cervical strain | Pain , stiffness on neck movement | Tenderness on palpation of neck and trapezius muscles | |
| "Whiplash" injury | Pain on neck movement following an abrupt extension–flexion type injury ,headache, shoulder or back pain, dizziness, paresthesias, fatigue | Decreased range of motion associated with neck spasm | |
| Cervical discogenic pain | Pain , stiffness on neck movement,cervical radicular symptoms | Decreased range of motion with pain | |
| Cervical myofascial pain | Focal pain and pressure sensitivity;accompanied by a sensation of burning or stinging | Localized tenderness | |
| Cervical radiculopathy | Pain, numbness,tingling in a dermatomal distribution,weakness in upper extremity | Decreased or altered sensation, diminished deep tendon reflexes | |
| Cervical spondylotic myelopathy | Lower extremity weakness, gait or coordination difficulties, and bowel or bladder dysfunction | Focal neurologic signs in upper and/or lower, Lhermitte's sign | |
| Ossification of the posterior longitudinal ligament | neck pain, progressive radiculopathy, myelopathy symptoms | Focal neurologic signs in upper and/or lower extremities | |
| Tension headache | Bilateral headache, which may be associated with neck pain; no other neurologic symptoms | Localized tenderness on palpation of scalp and neck,no neurologic abnormalities | |
| Coronary artery disease | Chest pain with radiation to neck | Normal | |
| Infection | Fever,depending on nature of infection | depending on nature of infection | |
| Malignancy | Unexplained weight loss | Localized tenderness on palpation of spine | |
| Referred shoulder pain | Shoulder pain with radiation to neck | Localized tenderness on shoulder exam | |
| Polymyalgia rheumatica | morning stiffness in shoulders | Decreased range of motion of joints | |
| Fibromyalgia | Diffuse musculoskeletal pain with fatigue | Multiple soft tissue "tender points | |
| Thoracic outlet syndrome | Upper extremity neurologic paresthesias,swelling, pain in the hand | Focal neurologic signs in upper extremities, sensory deficits, swelling, cyanosis or pallor | |
| Esophageal obstruction | Dysphagia | Normal |
References
- ↑ 1.0 1.1 Douglass AB, Bope ET (2004). "Evaluation and treatment of posterior neck pain in family practice". J Am Board Fam Pract. 17 Suppl: S13–22. doi:10.3122/jabfm.17.suppl_1.s13. PMID 15575026.
- ↑ Binder AI (2008). "Neck pain". BMJ Clin Evid. 2008. PMC 2907992. PMID 19445809.
- ↑ Binder A (2007). "The diagnosis and treatment of nonspecific neck pain and whiplash". Eura Medicophys. 43 (1): 79–89. PMID 17369782.
- ↑ Capó-Juan MA (2015). "[Cervical myofascial pain syndrome. Narrative review of physiotherapeutic treatment]". An Sist Sanit Navar. 38 (1): 105–15. doi:10.23938/ASSN.0058. PMID 25963463.