Cervicobrachialgia or radiating cervical pain What is it, what does it affect us and how can we deal with it?

What is cervicobrachialgia?

Cervicobrachialgia consists of the compression of a nerve root of the brachial plexus coming from the cervical spine, the most frequent being C6 and C7, producing motor or sensory disorders, or both. This pathology affects the cervical area (neck) and radiates to the arm and sometimes even to the hand.

 

Why does cervicobrachialgia originate?

It is an injury caused by inflammation of the nerve at its exit in the cervical or at another level of its route to the shoulder and can be produced by:

 

Herniated disc

The nerve is out of its space and compresses the nerve causing irritation to the nerve itself.

 

Spinal canal stenosis

It consists of a decrease in the space through which the medulla passes. Having less space, we find many compacted structures, causing inflammation of the nerve root.

 

Nerve compression

It may be caused by a muscle or bone structure:

• Scalenes: They are 3 muscles that we find in the anterior and lateral aspect of the neck. Between them passes the brachial plexus that comes out of the cervical and if we find tension in these muscles can compress the nerve.
• 1st rib: This bone together with the anterior scalene, subclavian and prevertebral muscles form a space through which the brachial plexus passes, as well as other structures such as arteries and veins. This space changes its volume with any activity of these muscles or even with breathing. So if we locate a compression of the plexus by these structures in this space we find what is called Thoracic Gorge Syndrome. The patient presents with pain, numbness of the arm and tingling that can even reach the fingers.
• Pectoralis minor: the final part of the brachial plexus passes between this muscle and the ribs. Therefore, if we find tension in this musculature, inflammation, etc., it can cause a compression of the plexus at this level producing the same symptoms mentioned above.

 

What are the symptoms?

Cervicobrachialgia is characterized by severe pain in the neck and upper back, radiating in this case to one or both arms.

This pain may even wake the person up at night. The patient reports a feeling of tiredness in the arm, cramps or tingling may even reach the fingers.

In turn, these symptoms cause pathologies at the shoulder level such as bursitis, irritation of the capsule, tendinopathies, etc., since there is an alteration of the movement of the arm causing the muscles not to act normally.

 

What are the treatments for cervicobrachialgia?

The treatment of this pathology is aimed at reducing pain and improving the functional capacity of the affected arm, thus improving the patient’s quality of life:

Conservative Treatment

It consists of resting for 2-3 weeks with the intake of analgesics, anti-inflammatory drugs and application of local heat (cervical area).

Physical Therapy Treatment

Within which we can find a more conventional treatment and a more innovative one.

Conventional Treatment

In this treatment we can apply Ultrasound and/or laser therapy in order to reduce the inflammation of the cervical area.

We can also apply microwaves, which consists of deep local heat to relax the muscles in the event that they are causing pain due to tension.

Magnet therapy that causes changes in the area of the injury, allowing the area to regenerate.

And finally, Manual Therapy with the objective of relaxing and normalizing all those structures (muscles, nerves, vertebrae, etc.) that need it.

 

Innovative Treatment

Within this treatment we can find the application of different techniques:

• Indiba: consists of a machine that provides heat to damaged tissues in order to reduce inflammation, nourish damaged cells, increase blood flow in the area and drain toxins, among other effects.

In this pathology we aim to reduce pain, eliminate tension and muscle spasms and facilitate the range of motion of the affected shoulder.

• Percutaneous Intratisular Electrolysis (PIE): consists of the application of a current by means of acupuncture needles and an ultrasound scanner, in order to know 100% where we prick, just in the damaged tissue, with the aim of causing inflammation on purpose so that the cells responsible for tissue regeneration and anti-inflammatory cells act on the tissue regenerating it.

The patient will notice a slight heat in the area that we will increase or decrease according to the patient’s tolerance and/or the degree of the pathology, whether acute or chronic.

• Percutaneous Neuromodulation (PNM): consists of the application of another type of electric current, by means of acupuncture needles and in an echo-guided manner, but this time acting on the nerves that innervate the injured areas.

In this way, by applying currents to these needles at a certain intensity, we will act on the pain, with the objective that these nerves stop sending pain signals to the brain and therefore the damaged structures stop hurting.

• Medical Therapies: Within these therapies we can find infiltrations, nerve blocks, in the case of vertebral damage (inflammation) or damage to the affected shoulder, (tendinopathy, bursitis, inflammation of the capsule, etc.) all these therapies will be performed with an ultrasound in order to act 100% on the damaged tissue.

With the infiltration we will achieve a significant decrease in inflammation of the damaged area by applying corticosteroids. Once the structure has been infiltrated, this decrease in inflammation will cause a decrease in pain and an increase in the movement of the shoulder.

• The nerve block consists of searching for the nerve that is causing the pain in the neck and/or shoulder area and performing a clamp in order to stop the nerve from sending pain signals to the affected structures.

It is important to know that this type of therapy must always be accompanied by physiotherapeutic treatment.

Surgical Treatment

In general it is usually the last step, having previously exhausted conservative treatments, physiotherapeutic and medical therapies. There are several options for such treatment:

In the case that was produced by a herniated disc, the protruding part is removed. If this part was pressing on a nerve causing pain, when it is removed the pain will decrease completely, however, if during the period that the disc was pressing on the nerve, it has permanently damaged the pain may remain and we would have to treat the nerve.

Another option is that there is little space in the holes where the cervical nerves exit. In this case, the intervention would consist of opening these spaces so that when the nerve passes through, it is not compressed.

It is important to know the risks involved in this type of intervention such as infections, loss of sensitivity, loss of mobility in the event that the surgeon sees fit to fix with a screw any vertebra, among many others. So in the end it is the patient who decides whether to undergo this operation or not.