Cervicobrachialgia refers to pain that originates in the cervical spine. It radiates into the arm.
What is cervicobrachialgia?
Cervicobrachialgia is when pain in the arm is caused by the cervical spine. Doctors also refer to it as cervicobrachialgia, cervicobrachial syndrome, cervicobrachial neuralgia, or shoulder-arm syndrome. Cervicobrachialgia is not a disease, but a description of a symptom. In addition, shoulder-arm syndrome corresponds to cervical spine syndrome in the middle and lower cervical spine. In most cases, cervicobrachialgia results from a herniated disc in the cervical spine (C-spine). The term cervicobrachialgia is made up of the terms cervicalgia (pain in the cervical spine) and brachialgia (arm pain derived from the arm nerves and nerve roots).
Causes
Numerous different causes are possible for cervicobrachialgia. Among the most common triggers is a herniated disc in the cervical spine. In this case, the prolapsed tissue of the intervertebral disc is responsible for a mechanical irritation of the outgoing nerve roots. As a result, there is a nerve root pain that extends into the wider body. The pain band varies according to the affected arm nerve or nerve root. The more intense and abrupt a nerve root irritation occurs, the further the pain progresses within the arm. Therefore, pronounced nerve root irritation can extend into the hand. If the pain is less intense and develops slowly, the symptoms end up in the upper arm or forearm. Another possible cause of cervicobrachialgia is wear-related narrowing of the nerve exit holes in the spine. The same applies to nerve inflammations such as plexus neuritis or vertebral joint cysts. However, certain diseases are also not infrequently the cause of shoulder-arm syndrome. These include uncovertebral arthrosis, which is a variant of cervical arthrosis, spondyloarthritis, muscular tension such as myogelosis, a blockage of the cervical spine, carpal tunnel syndrome, and muscular atrophy of the cervical muscles. Sometimes cervicobrachialgia is also caused by tumor disease of the brachial plexus or meningiosis neoplastica.
Symptoms, complaints, and signs
The symptoms of cervicobrachialgia usually result from temporary or permanent pressure on the cervical nerves. These nerves extend into the arm region. Depending on the severity of the shoulder-arm syndrome, the patient may experience intense headaches that radiate into the cervical region. The pain is either throbbing, dull or pulling. Sometimes they are also triggered by manual pressure on the cervical spine. As a rule, they do not manifest themselves chronically, but occur especially during prolonged lying down or in the morning after getting up. However, headaches are also possible during longer journeys by car. Another symptom is pronounced tension in the neck, which occurs simultaneously with arm pain, which is considered very unpleasant. In severe cases, patients also suffer from numbness.
Diagnosis and course
If cervicobrachialgia leads the patient to the doctor, the doctor first deals with the patient’s medical history. Also of importance is a physical examination. Here, the physician pays attention to nerve root irritations of the cervical spine at the C6 and C7 roots, because these occur most frequently. With a share of around 36 percent, they are responsible for most herniated discs. Imaging procedures such as an X-ray examination, computer tomography (CT) and magnetic resonance imaging (MRI) are also useful for diagnosis. Depending on the triggering cause of cervicobrachialgia, the nerve conduction velocity is also measured. Cervicobrachialgia can take either an acute or a chronic course. Chronic complaints last longer than three months. In such cases, more elaborate therapy is required.
Complications
Cervicobrachialgia usually results in relatively severe pain.These can spread to different regions of the body and cause pain even in areas of the body where the cause is not directly located. Thus, pain from the spine can also affect the arms. Likewise, the shoulders and the head of the affected person hurt, so that physical efforts are no longer possible. The patient’s performance is also reduced, he feels weak. Tension can occur in the neck, so that an unhealthy posture is usually adopted. Similarly, paralysis and numbness may occur in various parts of the body for a short time. The quality of life is relatively reduced by cervicobrachialgia. The constant pain can also have a negative effect on the psyche, leading to depression or irritability. In most cases, the pain is treated with the help of painkillers. These should not be taken for a long time, as they can damage the stomach. Likewise, physiotherapy measures are necessary to limit the symptoms in the long term. In some cases, surgical interventions are also necessary to treat cervicobrachialgia. However, pain often persists if the nerves have been damaged too severely.
When should you see a doctor?
With intense headaches and tension in the neck, be sure to consult your primary care physician. If numbness or severe pain in the arm and cervical spine is added, it is best to consult an orthopedist or chiropractor directly. Complaints and symptoms that have persisted for a long time or recur again and again are also a case for the specialist. In any case, cervicobrachialgia can only be diagnosed and treated by a medical professional. Patients who have had a herniated disc are particularly at risk. Also in consequence of a shoulder arm syndrome and with nerve inflammations it comes again and again to the intensive arm and cervical spinal complaints. To whom these factors apply, should speak with the responsible physician with mentioned signs. In addition, a conversation with a physiotherapist is recommended. This can often treat the complaints specifically and give tips on how cervicobrachialgia can be avoided in the future. In the case of chronic pain, however, medical treatment and aftercare is required in any case.
Treatment and therapy
Various options are available for the treatment of cervicobrachialgia, depending on the cause and extent of the condition. For the treatment of acute pain, analgesics such as diclofenac or ibuprofen and benzodiazepine-type muscle relaxants are usually administered. However, these preparations are only suitable for a limited period of time. In addition, the physician may inject the patient with a locally acting anesthetic. Chiropractic, acupuncture, and physiotherapeutic measures have proven effective as supportive treatments. Physiotherapy focuses on strengthening the muscles of the cervical spine. Heat or cold applications have only limited effect. The use of a neck brace is recommended only in acute cases. It relieves the cervical muscles to such an extent that there is a risk of their degeneration. In severe cases, cervicobrachialgia can also be treated surgically. However, this is only done if conservative measures are unsuccessful or if the symptoms are extremely severe. The risks of surgery are considered low and primarily include problems due to general anesthesia or wound infections. If a herniated disc is responsible for the cervicobrachialgia, the option is to operate out the prolapsed area. If the nerve was not previously damaged, pain relief is possible. Extensive removal of the vertebral body may require the use of a vertebral body prosthesis in some cases. Surgical therapy options also include spondylodesis. This involves limiting the mobility of one or two vertebral bodies. This is usually done by inserting screws. In this way, the spine is stiffened, which reduces the pain. In principle, however, the chances of success of surgical treatment of cervicobrachialgia are rather low, because the pain rarely improves.
Outlook and prognosis
The further course of cervicobrachialgia depends relatively strongly on the exact causes of this disease. For this reason, a general prognosis is usually not possible in this case. In most cases, however, the pain does not subside if it is not treated. Although the pain originates in the spine, it often spreads to neighboring regions, so that pain can occur in the shoulders or even the head. As it progresses, cervicobrachialgia then leads to neck tension and, in the worst cases, numbness or even paralysis. The patient’s everyday life is also negatively restricted by the permanent pain and the quality of life is reduced. Since the treatment of cervicobrachialgia also depends on its cause, no general course can be given here. However, the earlier the disease is diagnosed, the higher the chances of a complete cure. In severe cases, surgical interventions may be necessary to alleviate the symptoms. In most cases, however, cervicobrachialgia can also be relatively well limited with the help of exercises. The patient’s life expectancy is usually not reduced by the disease.
Prevention
To prevent cervicobrachialgia, it is recommended to strengthen the back muscles regularly. Furthermore, it is important to avoid one-sided stress on the spine.
Aftercare
Adequate aftercare for cervicobrachialgia depends on the cause of the condition in question. It is often a chronic-onset condition. This makes a general prognosis and generalized recommendation for follow-up difficult. In principle, however, the same applies to follow-up care as to preventive care; the individual cause must be counteracted. If there is no contraindication, physiotherapeutic exercises and applications help to prevent renewed pain and movement restrictions. Various exercises serve to strengthen and loosen the muscles of the cervical vertebrae. In addition, strengthening the deep back muscles also has a beneficial effect on well-being. The spine and explicitly the pain-associated zones should be spared and one-sided loads should be avoided. If the cause of cervicobrachialgia is degenerative changes in the spine, such as after a herniated disc or muscle weaknesses, regular checks should be scheduled by the attending physician to prevent the symptoms from recurring. In some cases, it may be necessary to adapt the environment at home and at work. An ergonomically adapted workplace allows for a corrected and gentle posture. In particularly severe cases, heavy physical work should no longer be performed. Heavy carrying should be avoided. As part of self-help for recurring pain, therapeutic baths, red light or heat treatments, or ice compresses can provide relief.
This is what you can do yourself
Among the most common causes of cervicobrachialgia are other degenerative changes in the cervical spine in addition to a herniated disc. A sufferer should definitely see a doctor if he or she experiences symptoms. If degenerative conditions are detected at an early stage, they can often be successfully treated without surgical intervention. In the case of an incipient herniated disc and other degenerative disorders of the cervical spine, the patient should immediately begin physiotherapy. However, the success of this depends to a large extent on the patient’s cooperation. During therapy, the patient learns a series of exercises that loosen and strengthen the muscles of the cervical spine. These exercises usually have to be done regularly not only at the physiotherapist’s office, but also at home. In addition, a variety of other behavioral adjustments are often required. Often, the workplace must be ergonomically aligned and posture corrected while working at a computer screen. People who perform heavy physical work are often no longer allowed to perform certain activities. Corresponding medical prohibitions should be strictly observed. In acute pain, some patients react positively to heat or cold. An affected person should test his or her reaction to changes in temperature. If there is a positive reaction to heat, full baths, hot water bottles and red light are suitable for treatment.Those who respond better to cold should use ice compresses from a pharmacy or medical supply store.
