Cervicobrachialgia is when pain in the arm is caused by the cervical spine. Doctors also speak of cervicobrachialgia , cervicobrachial syndrome , cervicobrachial neuralgia , or shoulder-arm syndrome . Cervicobrachialgia is not a disease, but a description of a symptom.

In addition, the shoulder-arm syndrome corresponds to a cervical spine syndrome in the middle and lower cervical spine section. In most cases, cervicobrachialgia is caused by a herniated disc in the cervical spine (cervical spine).

The term cervicobrachialgia is composed of the terms cervicalgia (pain in the cervical spine) and brachialgia (arm pain derived from the arm nerves and nerve roots).

causes

There are many different causes of cervicobrachialgia. One of the most common triggers is a herniated disc in the cervical spine. The prolapsed tissue of the intervertebral disc is responsible for mechanical irritation of the outgoing nerve roots. As a result, there is nerve root pain that extends into the rest of the body.

The pain band runs differently and depends on 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 reach into the hand. If the pain is less intense and only develops slowly, the symptoms end in the upper arm or in the forearm.

Another possible reason for cervicobrachialgia is wear-related narrowing of the nerve exit holes in the spine. The same applies to nerve inflammation such as plexus neuritis or vertebral joint cysts. However, certain diseases are also often the cause of shoulder-arm syndrome .

These include uncovertebral arthrosis, which is a variant of cervical spine arthrosis, spondylarthrosis , muscular tension such as myogelosis , a blockage of the cervical spine, carpal tunnel syndrome and muscular atrophy of the neck muscles. Occasionally, cervicobrachialgia is also caused by a tumor disease of the brachial plexus or neoplastic meningeosis.

Symptoms, Ailments & Signs

The symptoms of cervicobrachialgia usually arise from temporary or permanent pressure on the nerves in the cervical spine. These nerves reach into the arm region. Depending on the severity of the shoulder-arm syndrome, intense headaches appear 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 are not chronic, but occur particularly when lying down for a long time or in the morning after getting up. Headaches are also possible during long car journeys.

Another symptom is pronounced tension in the neck , which occurs at the same time as arm pain, which is considered very uncomfortable. In severe cases, patients also suffer from numbness .

Diagnosis & History

If the cervicobrachialgia leads the patient to the doctor, the doctor first deals with his or her medical history. A physical examination is also important. The doctor pays attention to nerve root irritations of the cervical spine at the roots C6 and C7, because these occur most frequently. With a share of around 36 percent, they are responsible for most herniated discs.

Imaging methods such as an X-ray examination , computed tomography (CT) and nuclear spin tomography (magnetic resonance imaging) are also useful for diagnosis . Depending on the triggering cause of cervicobrachialgia, the nerve conduction velocity is also measured.

Cervicobrachialgia can take both an acute and a chronic course. Chronic complaints last longer than three months. In such cases, more complex therapy is required.

complications

Cervicobrachialgia usually causes relatively severe pain. These can spread to different regions of the body and also cause pain in areas of the body where the cause is not directly located. Thus, pain from the spine can also affect the arms.

The shoulders and head of the affected person also hurt, so that physical exertion is no longer possible. The patient’s performance is also reduced, and he feels weak. Tension can arise in the neck, so that an unhealthy posture is usually adopted. Short-term paralysis and numbness can also occur in various parts of the body.

The quality of life is relatively greatly reduced by cervicobrachialgia. The constant pain can also have a negative effect on the psyche and lead to depression or irritability. In most cases, the pain is treated with painkillers. These should not be taken for a long time, as they can damage the stomach.

Physiotherapy measures are also necessary to limit the symptoms in the long term. In some cases, surgical interventions are also necessary to treat the cervicobrachialgia. However, the pain often persists if the nerves have been damaged too severely.

When should you go to the doctor?

If you have an intense headache and tension in your neck, you should definitely consult your family doctor . If you experience numbness or severe pain in the arm and cervical spine, it is best to consult an orthopedist or chiropractor directly . Complaints and symptoms that have existed for a long time or occur again and again are also a case for the specialist. In any case, cervicobrachialgia can only be diagnosed and treated by a doctor.

Patients who have had a herniated disc are particularly at risk. Also as a result of a shoulder-arm syndrome and nerve inflammation, the intensive arm and cervical spine complaints occur again and again. If these factors apply to you, you should speak to the doctor responsible if you notice the symptoms mentioned.

It is also advisable to talk to a physiotherapist . They can often treat the symptoms in a targeted manner and give tips on how to avoid cervicobrachialgia in the future. However, chronic pain always requires medical treatment and aftercare.

Treatment & Therapy

Various options are available for the treatment of cervicobrachialgia, depending on the cause and the extent of the condition. Painkillers such as diclofenac or ibuprofen and benzodiazepine-type muscle relaxants are usually used to treat acute pain . However, these preparations are only suitable for a limited period of time.

In addition, the doctor can inject the patient with a local anesthetic. Chiropractic , acupuncture and physiotherapeutic measures have proven to be supportive treatments . Physiotherapy focuses on strengthening the cervical spine muscles . Heat or cold applications only have a limited effect.

The use of a neck brace is only recommended in acute cases. They relieve the neck muscles to such an extent that there is a risk of their degeneration as a result. In severe cases, cervicobrachialgia can also be treated surgically. However, this only happens if the conservative measures are unsuccessful or if the symptoms are extremely severe.

The risks of an intervention are considered to be low and primarily include problems caused by general anesthesia or wound infections . If a herniated disc is responsible for the cervicobrachialgia, there is the option of operating on the area that protruded. If the nerve was not previously damaged, a reduction in pain is possible.

In the case of extensive removal of the vertebral body, a vertebral prosthesis must be used in some cases. Spondylodesis is also one of the surgical treatment options. The mobility of one or two vertebral bodies is restricted.

This is usually done by inserting screws. This stiffens the spine, which reduces pain. In principle, however, the chances of success of surgical treatment of cervicobrachialgia are considered rather low because the pain rarely improves.

Outlook & Forecast

The further course of cervicobrachialgia depends relatively heavily on the exact causes of this disease. For this reason, a general prognosis is usually not possible. Most of the time, however, the pain does not go away if left untreated. Although the pain comes from the spine, it often spreads to neighboring regions, causing pain in the shoulders or even the head.

In the further course, the cervicobrachialgia then leads to neck tension and, in the worst case, to numbness or even paralysis . The permanent pain also negatively affects the patient’s everyday life and reduces the quality of life.

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 serious cases, surgical interventions may also be necessary to relieve the symptoms. In most cases, however, cervicobrachialgia can also be limited relatively well with the help of exercises. The patient’s life expectancy is usually not reduced by the disease.

prevention

To prevent cervicobrachialgia, it is advisable to regularly strengthen the back muscles. It is also important to avoid one-sided strain on the spine.

aftercare

Adequate aftercare for cervicobrachialgia depends on the cause of the disease in question. It is often a chronic disease. This complicates a general prognosis and generalized recommendation for follow-up care. In principle, however, the same applies to aftercare as to preventive care; the individual cause must be counteracted.

If there are no contraindications, physiotherapeutic exercises and applications help to prevent renewed pain and restricted mobility. Various exercises serve to strengthen and loosen the cervical vertebrae muscles. In addition, strengthening the deep back muscles also promotes well-being. The spine and explicitly the pain-associated zones should be protected and one-sided loads avoided.

If the cause of cervicobrachialgia is degenerative changes in the spine, for example after a herniated disc or muscle weakness, regular check-ups should be scheduled by the doctor in charge to prevent the symptoms from recurring. In some cases, it may be necessary to adapt the environment in private and at work.

An ergonomically adapted workplace enables a corrected and gentle posture. In particularly severe cases, no more heavy physical work should be done. Avoid heavy carrying. As part of self-help for recurring pain, therapeutic baths, red light or heat treatments or ice compresses can provide relief.

You can do that yourself

The most common causes of cervicobrachialgia include a herniated disc and other degenerative changes in the cervical spine. A person affected should definitely consult a doctor in the event of symptoms.

If degenerative diseases are recognized early, they can often be successfully treated without surgery. If a herniated disc or other degenerative disorders of the cervical spine begin, the patient should start physiotherapy immediately. However, their success depends heavily on the cooperation of the patient. During the therapy, he learns a series of exercises that loosen and strengthen the muscles of the cervical spine.

These exercises usually have to be completed not only with the physiotherapist , but also at home on a regular basis. In addition, a variety of other behavioral adjustments are often required. The workplace often has to be ergonomically aligned and the posture corrected while working on the screen. People who do heavy physical work are often no longer allowed to do certain jobs. Appropriate medical prohibitions should be strictly observed.

In the case of acute pain, some patients react positively to heat or cold. A sufferer should test their response to temperature changes. 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 the cold should use ice compresses from the pharmacy or medical supply store.