Under a Cervicobrachialgie pain be understood that emanate from the cervical spine. They radiate up to the arm.
What is cervicobrachialgia?
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 sections. 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, which is derived from the arm nerves and nerve roots).
There are numerous possible causes for cervicobrachialgia. One of the most common triggers is a herniated disc in the cervical spine. The herniated tissue of the intervertebral disc is responsible for mechanical irritation of the outgoing nerve roots. As a result, nerve root pain occurs that extends into the wider body.
The pain band runs differently and depends on the affected arm nerve or the 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 occurs 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 inflammations such as plexus neuritis or vertebral joint cysts. But also certain diseases are not infrequently the originator of a 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, a carpal tunnel syndrome and muscular atrophy of the neck muscles. Sometimes cervicobrachialgia is also caused by a tumor disease of the brachial plexus or a neoplastic meningiosis.
Symptoms, ailments & signs
The symptoms of cervicobrachialgia usually arise from temporary or permanent pressure on the cervical spinal nerves. These nerves extend 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 especially when lying down for a long time or in the morning after getting up. But headaches are also possible on longer journeys by car.
Another symptom is pronounced tension in the neck, which occurs at the same time as arm pain, which is considered to be very uncomfortable. In severe cases, patients also suffer from numbness.
Diagnosis & course
If the cervicobrachialgia leads the patient to the doctor, the doctor first deals with the patient’s medical history. A physical exam is also important. The doctor pays attention to nerve root irritation of the cervical spine at roots C6 and C7, because these are the most common. With a share of around 36 percent, they are responsible for most of the herniated discs.
Imaging methods such as an X-ray examination, computed tomography (CT) and magnetic resonance tomography (magnetic resonance tomography) are also useful for diagnostics. Depending on the triggering cause of cervicobrachialgia, the nerve conduction velocity is also measured.
Cervicobrachialgia can take an acute as well as a chronic course. Chronic complaints last longer than three months. In such cases, more complex therapy is required.
Cervicobrachialgia usually results in 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 person affected also hurt, so that physical exertion is no longer possible. The patient’s performance is also reduced, he feels weak. There can be tension 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 reduced to a relatively large extent by the 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 the help of pain relievers. These should not be taken for a long time, as they can damage the stomach.
Physiotherapy measures are also necessary in order to limit the symptoms in the long term. In some cases, surgical interventions are also necessary to treat cervicobrachialgia. Often, however, the pain remains if the nerves are damaged too much.
When should you go to the doctor?
If you have intense headaches and tension in your neck, you should definitely consult your doctor. In the event of 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. As a result of a shoulder-arm syndrome and nerve inflammation, the intense arm and cervical spine complaints occur again and again. To whom these factors apply, should speak to the responsible doctor if the symptoms mentioned.
A conversation with a physiotherapist is also recommended. This can often treat the complaints in a targeted manner and give tips on how to avoid cervicobrachialgia in the future. In the case of chronic pain, however, medical treatment and follow-up care are always required.
Treatment & Therapy
There are various options available for treating cervicobrachialgia, depending on the cause and extent of the condition. For the treatment of acute pain, pain relievers such as diclofenac or ibuprofen and muscle relaxants of the benzodiazepine type are usually administered. However, these preparations are only suitable for a limited period of time.
The doctor can also inject a topical anesthetic into the patient. Chiropractic, acupuncture and physiotherapeutic measures have proven effective as supportive treatments. The physical therapy relies on the strengths of the cervical muscles. Applications of heating or cooling have only a limited effect.
The use of a ruff is only recommended in acute cases. They relieve the neck muscles so much that they threaten to degenerate as a result. In severe cases, cervicobrachialgia can also be treated surgically. However, this only happens if the conservative measures are unsuccessful or if there are extremely strong symptoms.
The risks of an intervention are considered to be low and primarily involve problems caused by general anesthesia or wound infections. If a herniated disc is responsible for the cervicobrachialgia, there is the option of operating out the herniated area. If the nerve has not been damaged before, a reduction in pain is possible.
In some cases, if the vertebral body is extensively removed, a vertebral body prosthesis must be used. Spondylodesis is also one of the surgical therapy options. This restricts the mobility of one or two vertebral bodies.
This usually takes place by inserting screws. This will stiffen the spine, which will reduce pain. In principle, however, the chances of success of surgical treatment of cervicobrachialgia are rather low, because the pain rarely improves.
Outlook & forecast
The further course of cervicobrachialgia depends to a large extent on the exact causes of this disease. For this reason, a general forecast is usually not possible. Most of the time, however, the pain will not go away if left untreated. Although the pain comes from the spine, it often spreads to neighboring regions as well, 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 constant 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 severe cases, surgical interventions may also be necessary to alleviate the symptoms. In most cases, however, cervicobrachialgia can also be limited relatively well with the help of exercises. The life expectancy of the patient is usually not reduced by the disease.
To prevent cervicobrachialgia, it is advisable to strengthen the back muscles regularly. It is also important to avoid unilateral loads on the spine.
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 is no contraindication, physiotherapeutic exercises and applications help to prevent renewed pain and movement restrictions. Different exercises serve to strengthen and loosen the cervical muscles. In addition, strengthening the deep back muscles is beneficial for wellbeing. The spine and explicitly the pain-associated zones should be spared and one-sided loads should be avoided.
If the cause of the cervicobrachialgia is degenerative changes in the spine, for example after a herniated disc or muscle weakness, regular check-ups should be scheduled by the attending physician in order 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 workstation enables correct and gentle posture. In particularly severe cases, no more heavy physical work should be performed. It is important to avoid heavy carrying. As part of self-help with recurring pain, therapeutic baths, red light or heat treatments or ice compresses can provide relief.
You can do that yourself
In addition to a herniated disc, the most common causes of cervicobrachialgia include 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 and other degenerative disorders of the cervical spine are beginning, the patient should immediately begin physiotherapy. However, their success depends heavily on the cooperation of the patient. During therapy, he 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 with the physiotherapist, but also at home. In addition, a large number of other behavioral adjustments are often required. Often the workplace has to be ergonomically aligned and posture corrected while working on the screen. People who do heavy physical work are often no longer allowed to perform certain activities. Corresponding medical prohibitions should be strictly observed.
In acute pain, some patients respond positively to heat or cold. An affected person should test his or her reaction to changes in temperature. If the reaction to heat is positive, full baths, hot water bottles and red light are suitable for treatment. If you respond better to the cold, you should use ice compresses from the pharmacy or medical retailer.