Differential Diagnosis
| Origin | Pain Location | Exacerbation | Physical Examination | Diseases |
| Cervical Spine | Back of neck/head + shoulder/upper arm | Neck movements | 1. Limitation of neck motion 2. Tenderness to palpation over the cervical spine | OA, Osteophytes, Cervical disc herniation, RA, Trama, Whiplash injury, cervical spondylosis, thoracic outlet syndrome |
| Brachial Plexus | Supraclavicular region/ axilla/shoulder | Arm and neck movements/maneuvers (ex. external rotation) | Palpable abnormality above the clavicle | Brachial neuritis, metastatic infiltration, radiation damage to the plexus |
| Shoulder | Shoulder + (arm) | Shoulder motion | Tenderness and limitation of movement (internal/external rotation/abduction) sensorimotor and reflex changes (-) | Rotator cuff injury/tear, subacromial/subdeltoid bursitis, periarthritis or capsulitis (frozen shoulder), tendonitis, and arthritis, MI, Sudeck atrophy or Sudeck-Leriche syndrome |
*Whiplash injury: If NE (+), consider brain, spinal cord injury, or carotid or vertebral artery dissection
Disc Herniation
Definition: tear in outer ring, annulus fibrosis (AF), and bulging of nucleus pulposus (NC). Usu. posterolateral
Most common: 30 ~40 y/o
b/c NC still gelatin-like.
>40 y/o
NC dehydrated, reduced risk of herniation
