A Pancoast tumor and a pinched nerve can both cause shoulder and arm pain, weakness, numbness, and tingling. However, a pinched nerve is a much more common condition.
Pancoast tumors are a rare form of lung cancer. According to Cancer Research UK, less than 5% of all lung cancer cases are Pancoast tumors.
Pancoast tumors can also cause additional symptoms that a pinched nerve does not, such as fatigue, a drooping eyelid, and unintentional weight loss.
Read on to learn the main differences between Pancoast tumors and a pinched nerve, including a comparison of symptoms and treatments.
A pinched nerve occurs when tissues, such as muscle, bone, or cartilage, press on a nerve. This pressure can stop the nerve from working as it should, causing pain or changes in sensation.
A pinched nerve can develop in many locations around the body, but it often affects the neck, spine, or wrist.
In contrast, Pancoast tumors are a rare type of lung cancer that occurs in the tops or “apex” part of the lungs. Typically, these growths occur in
Because of their location, Pancoast tumors can press on a group of nerves known as the brachial plexus, which runs into the neck and arms. This pressure can cause symptoms similar to those of a pinched nerve.
Below is a table summarizing the main differences:
| Pinched nerve | Pancoast tumor | |
|---|---|---|
| Cause | Compression of a nerve | Cancerous growth |
| Location | Often the neck or spine | Apex of the lungs |
| Prevalence | Common | Rare |
Both Pancoast tumors and a pinched nerve can cause:
- sharp or burning pain in the shoulder or arm
- weakness in the shoulder or arm
- a loss of sensation or numbness
- tingling or “pins and needles” in the arm or hand, also known as paresthesia
However, Pancoast tumors have some additional symptoms that set them apart from a pinched nerve. This includes Horner’s syndrome, a group of symptoms that includes:
- flushing on one side of the face
- a drooping or weak eyelid on one side of the face
- a small pupil on the same side
- a lack of facial sweating
Other potential signs of Pancoast tumor include fatigue or unintentional weight loss.
A pinched nerve alone will not cause these symptoms. However, it is important to note that Horner’s syndrome has
For this reason, people cannot diagnose themselves based on symptoms alone.
The causes of a pinched nerve in the neck can include:
- an injury
- degenerative conditions, such as arthritis or spondylosis
- a herniated disk
Degenerative changes in the spine are the most common cause. To an extent, these changes occur in almost everyone as they get older, but not everyone develops pain or other symptoms. Doctors are not sure why some people do and some do not.
Pancoast tumors develop when cells change and become cancerous. Risk factors for Pancoast tumors are similar to those of other lung cancers, and
- smoking
- radon exposure
- previous radiation therapy to the chest
- family history of lung cancer
A doctor will be able to tell the difference between a Pancoast tumor and a pinched nerve. To begin the process of making a diagnosis, they will ask a person about their symptoms and take a medical history.
Next, they may perform diagnostic tests, such as:
- a physical examination
- an X-ray
- a CT, MRI, or PET scan
- electromyography (EMG), which measures the electrical activity in muscles
- a biopsy, if necessary
If a person has a pinched nerve, EMG may show that nerves are not working as they should. Imaging scans may also help to reveal compression or another potential cause of the pain, such as bone spurs.
If the cause is a tumor, imaging scans may provide visuals of the tumor. However, in the early stages, a Pancoast tumor can sometimes be challenging to see on an X-ray alone. Other imaging scans or a biopsy can confirm if it is a tumor.
Misdiagnosis and Pancoast tumors
Because of the similarities between Pancoast tumor symptoms and other conditions, some people
Being aware of the distinctive symptoms Pancoast tumors can cause, such as Horner’s syndrome, may allow people to monitor for any warning signs and report them promptly to a doctor.
Despite having similar symptoms, a pinched nerve and Pancoast tumor each have very different treatments.
Pinched nerve treatments
A pinched nerve will often get better on its own. For a pinched nerve in the neck, the recovery time can be days or weeks. During this time, a person may not need treatment, although pain medications may help reduce symptoms.
If the symptoms do not get better with time, a doctor may suggest:
- physical therapy
- anti-inflammatory oral medications
- steroid injections
- a cervical collar, if appropriate
If these options do not help, a doctor may suggest stronger pain medications or surgery.
Pancoast tumor treatments
Treatment for Pancoast tumors will depend on several factors, including:
- the type of tumor
- how advanced it is
- its exact location
Most Pancoast tumors are nonsmall cell cancers, often a type known as adenocarcinomas. These are cancerous.
Depending on a person’s situation, the treatment options may include:
- chemotherapy
- radiation
- surgery, which requires specialist surgeons
- immunotherapy
- targeted therapy
- supportive care to reduce symptoms
Getting a diagnosis as soon as possible may help improve outcomes.
A person with persistent or severe pain, tingling, or weakness in the shoulder or arm should speak with a doctor.
Several things can cause these symptoms, some of which may need medical treatment. Consulting a medical professional allows them to make a diagnosis and recommend treatments that are most likely to work.
If a person also has symptoms that could indicate Horner’s syndrome, it is imperative to speak with a doctor as soon as they can.
However, if the following symptoms come on suddenly, do not hesitate to get emergency help:
- facial drooping
- inability to raise one or both arms
- speech difficulties, such as slurring
- difficulty with balance or walking
- vision changes
- severe headache
- confusion
These could be symptoms of a stroke. If they occur, dial 911 immediately and do not attempt to drive to the hospital.
Below are answers to common questions about Pancoast tumors and pinched nerves.
Yes, a specific type of lung cancer known as a Pancoast tumor can cause symptoms similar to those of a pinched nerve. However, people with Pancoast tumors can also have other symptoms, such as Horner’s syndrome.
Medical tests may rule out a Pancoast tumor by identifying the cause of someone’s symptoms. For example, an EMG may identify nerve dysfunction, while an X-ray may find bone spurs or an injury.
Pancoast tumors typically affect older adults. On average, people who have this condition get a diagnosis in their 70s.
A pinched nerve and Pancoast tumor are two very different conditions that share some of the same symptoms, including shoulder and arm pain.
However, a pinched nerve is a much more common condition that usually goes away in days or weeks. Many people get better without treatment.
In contrast, Pancoast tumors require medical treatment. A doctor can determine what is causing a person’s symptoms by examining them and performing tests.