Neck Pain Differential Diagnoses

Differential Diagonses

Chronic Neck Pain

• Zygapophyseal joint pain (~40%)
• Cervical disc pain (~40%)
• Combined ZA joint and disc pain (~20%)
• Systemic causes such as rheumatoid arthritis, ankylosing spondylitis.
• Infections (bones, joints, discs, epidural abscess, and meningitis)
• Tumours
• DISH and ossification of the posterior longitudinal ligament
• Chronic BPPV

Acute Neck Pain

Neck pain can result from any innervated cervical spine structure

• "Cervical sprain"
• Discogenic pain
• Zygapophyseal joint pain
• C0/C1 and C1/C2 lateral joints
• Muscle sprain
• Segmental dysfunction
• Vascular disorders: dissection of vertebral artery, internal carotid artery, or aneurysm of the descending thoracic aorta.
• Fracture
• DISH and ossification of the posterior longitudinal ligament
• Tumours
• Infections (bones, joints, discs, epidural abscess, and meningitis)
• Epidural haematoma
• Calcific tendinitis of the longus colli muscles

Cervicogenic Headache

• C1
  • Joints: Median C1/2, C0/1,
  • Ligaments: Transverse C1/2 ligament, Alar ligament
  • Muscles: Prevertebral, sternomastoid, trapezius, suboccipital
  • Dura: Upper spinal cord, posterior cranial fossa
  • Arteries: Vertebral and internal carotid arteries
• C2
  • Joints: Lateral C1/2
  • Muscles: Semispinalis, Splenius
• C2
  • Joints: C2/3 ZA joint, C2/3 disc
  • Muscles: Mutifidus, semispinalis

See Also

• Causes and Sources of Neck Pain
• Cervical Pain Maps