Neck Pain Differential Diagnoses

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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