Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
La sciatica does not mention still only pain in the leg. In some cases, it also affects the upper limb. It is then called sciatica of the arm.
This condition, also called cervico brachial neuralgia, is a surprisingly fairly common one. It is felt in the upper limbs, and can greatly affect daily activities.
This article explains this condition in detail, with a focus on concrete and ideally natural solutions to relieve you.
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What exactly is arm sciatica?
Sciatica of the arm, or cervicobrachial neuralgia, refers to a pain which spreads from the neck to the upper limbs of the body.
Although there are several possible causes, pain most often occurs when the disk which separates two vertebrae of your neck suffers an injury. We then feel a pain that starts from the neck, through the upper back, the scapula, the clavicle, the shoulder, until it extends along the arm.
The degree of pain intensity varies depending on the ill person. It can cause paresthesias in the upper limb (such as ants in hand).
In the worst case, sciatica of the arm can lead to paralysis of the upper limbs, and a feeling of electric shock. When pain persists, it can seriously affect the sufferer's quality of life.
Causes: What causes arm sciatica?
La arm sciatica is one of the most frequent causes of consultation in rheumatology. It is placed after lumbago and sciatica. This disease affects many people, especially women. It concerns not only the elderly, but also young people.
Our cervical vertebrae must withstand the pressures caused by the weight and mobility of our head. In some cases, they suffer major trauma such as cervical sprains.
At this stage, we often find deformations of the edges of the vertebrae (like parrot beaks) and deterioration of the discs which irritate the nerves and cause the symptoms.
cervical hernia
Cervical hernia occurs mainly in young people (under 40 years old). At first, the disease may cause tolerable pain (or even no pain). If the cervical discs affected by the herniated disc irritate the corresponding nerves, and are accompanied by inflammation, the typical symptoms of cervico-brachialgia neuralgia are then observed.
The nerve roots become irritated in the presence of prolonged static postures, movement of the upper limbs, or during lifting of loads.
At this time, the pain intensifies and sometimes becomes constant. Indeed, the patient may suffer from inflammation of the cervical root.
In addition to the causes mentioned above, there are other conditions potentially responsible for neck pain radiating to the upper limb.
The tumor, heredity, a fracture at the cervical level, or a malformation can also be at the origin of the cervicarthrose. In addition, sciatica of the arm can be related to pregnancy, muscle contracture, or even a Scoliosis.
This disease causes shooting pains in the upper limbs of the body. The painful areas extend from the neck to the arm, passing through the collarbone and the shoulders.
In short, they follow the course of the reduced nerve. Each nerve that emerges from the cervical spine provides sensation to a particular area of the body. This is called a dermatome. Depending on the irritated nerve, the patient will feel pain following a specific pattern.
It is even possible that these pains go up towards the head or the jaw, and cause headaches. They are amplified as the patient makes movements (of the head or arms). The pain is both mechanical and inflammatory.
Other symptoms may also appear such as a feeling of stiffness in the neck, intense migraines, muscle disorders, sensory disturbances, dizziness, as well as a strong feeling of fatigue.
The patient may also feel tingling, numbness, or even electric shocks and weakness in the affected upper limb. Again, this is due to the affected nerve root that provides sensation and strength to certain arm muscles.
However, it should be understood that the cervico-brachialis does not always cause pain. Some sick people may have osteoarthritis or cervical hernia, without feeling the slightest symptom.
Why is that ? One reason is the tremendous adaptability of the human body. If the osteoarthritic changes have been gradual, and are not related to an inflammatory process, it is possible to feel no pain.
The diagnosis
Le health professional (such as a family doctor, rheumatologist, orthopedic surgeon, etc.) is able to diagnose arm sciatica. During the consultation, he must carry out a clinical examination of the disease. For this, he must define the degree of intensity, the variation as well as the route of the pain in his patient.
Subsequently, he examines and palpates along the spine. He also studies the mobility of the neck and analyzes the patient's upper limbs. Thanks to the physical examination, the treating professional generally manages to confirm or not the presence of this pathology.
Once the physical examination is complete, the doctor can then resort to imaging exams if he deems it necessary. For example, standard x-rays are useful to reveal the presence of osteoarthritis, osteophytes or growths in the bones.
MRI (magnetic resonance imaging) scans of the cervical spine are also possible. They allow the physician to determine the source of nerve compression, as well as the effects on spinal cord.
The CT scan of the cervical spine is also useful to reveal the presence of a herniated disc or osteoarthritis. Depending on the results, the doctor can, for example, determine whether the patient is a good candidate for surgery (in severe cases).
As mentioned previously, there may be osteoarthritis or cervical hernia visible on MRI, but which does not necessarily cause significant pain. It is for this reason that it is always important to correlate findings withmedical imaging with a complete clinical examination.
Treatment: How to cure arm sciatica?
Here is a list of treatments (not exhaustive) to relieve arm sciatica :
Analgesic and anti-inflammatory drugs
These drugs are prescribed by the doctor. These are generally excellent remedies for pain relief, although many patients are reluctant to take medication. Muscle relaxants (muscle relaxants) are also effective in relaxing tight muscles in your neck.
Generally, ice is recommended when the pain is acute and recent. Conversely, heat would help relax tense muscles and induce a relaxing environment.
To learn all about heat and ice in the treatment of back pain (and which one to choose), see the following article.
Wearing a cervical collar
Also called neck brace, it is a device that consists of holding the cervical vertebrae immobile. Although it may reduce symptoms temporarily, it limits neck mobility and prevents optimal activation of cervical muscles. For this reason, it is best to limit its use as much as possible.
Rehabilitation in physiotherapy (physiotherapy)
It is used in particular to improve cervical mobility and tone the muscles around the cervical vertebrae. This practice also reduces the intensity of pain caused by muscle disorders. Rehabilitation also allows a return to sport (including bodybuilding) in an effective and safe way.
Alternative treatments
Although not supported by solid scientific evidence, several alternative treatments are used to relieve symptoms and treat arm sciatica. Among the methods used are:
Used in homeopathy and naturopathy, natural products include non-pharmacological products such as essential oils, natural ointments, food supplements, etc.
In this practice, we inject cortisone at the vertebral level reached to reduce the inflammatory process responsible for the symptoms. It is used when medication and rehabilitation does not provide significant relief.
It is used quite rarely considering the surgical risks. This is because serious damage to nerve structures (such as the spinal cord), as well as persistent, incapacitating pain that has not responded to conservative treatment, is required before any more invasive approach can be considered.
In this practice, the surgeon may be required to stabilize the affected cervical vertebrae and remove the compression of the nerve.
Note: The duration of these treatments varies according to the severity of the condition, the duration of the symptoms and the general state of the patient. The health professional is the resource person to prescribe the care adapted to your condition.
Prognosis: How long does arm sciatica last?
When diagnosed with cervico-brachial neuralgia, it is normal to wonder how long the symptoms and disability will last. Obviously, this answer will vary depending on several factors, and depending on each condition. Some of the most important things to keep in mind include:
The severity of the condition
Be careful, do not think that the intensity of the symptoms is always proportional to the severity of the cervical lesions as demonstrated by medical imaging.
In other words, it doesn't mean that your disc is badly affected, or that the level of degeneration in your cervical spine is high, if you feel more pain for a given period.
On the other hand, it is believed that the higher the level of inflammation, the more severe the condition and will take longer to heal. This is especially true if related structures are also affected (spinal nerves, spinal cord, etc.)
The duration of symptoms
That's a fact. Chronic pain is generally more complex to treat than acute pain (for a multitude of reasons that are beyond the scope of this article).
On the other hand, remember this: Pain that persists over time is “crystallized” in the nervous system. It's as if the brain had become acclimatized to pain, and continues to send painful messages by automatism and by apprehension of a danger (real or potential).
It is for this reason that arm sciatica that lasts for more than 3-6 months is believed to be more difficult to treat, and will require a tailored treatment approach.
Pain radiation
In general, pain that is more localized in the cervical region has a better prognosis (ie it is normally easier to treat, and heals faster).
As for pain that radiates to the upper limb, it is generally said that the further down the arm it goes (for example down to the fingers, unlike radiation to the shoulder only), the less favorable the prognosis.
Note that the Mckenzie method, a treatment technique regularly used in kinesitherapy (physiotherapy), precisely seeks to identify directions of movement allowing to reduce the irradiation of pain, and to promote the healing of neuralgia and others.
Psychosocial factors
When we have arm sciatica, we often think that the cause relates only to our vertebrae, nerves, joints, or intervertebral discs. But we must not forget that pain is a signal coming from the brain.
All pain is multifactorial, and has a significant emotional component. The separation of physical and psychological to explain health problems (especially neck pain and low back pain) is a mistake that many clients - and even some therapists - make.
As the stress frequently responsible for physical disorders (for example by increasing the muscular tensions at the cervical level), one can say that the psychological component will influence the prognosis of cure. The same is true for our social, professional and family relationships.
The level of physical activity
The benefits of physical exercise no longer need to be demonstrated. Moreover, many studies establish links between a sedentary lifestyle, back pain and herniated discs.¹. As said before, certain prolonged postures can be a prelude to musculoskeletal disorders.
With this in mind, it is easy to conceive that a sedentary individual will take longer to heal. On the contrary, here is the good news of the day: a generally active individual will see his pain disappear more quickly!
Good recovery !
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