Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
La cervico brachial neuralgia is a fairly common condition. It is felt in the upper limbs, and can greatly affect daily life and work. Fortunately, several natural treatments are available to relieve this pain and avoid the operation.
To do this, it is essential to identify the cause of the symptoms, and know the procedure to follow to relieve the symptoms in addition to preventing the aggravation of the condition.
What is cervico-brachial neuralgia? What are its causes and symptoms? What is the best way to treat it Discover in this article all the necessary and interesting information about this disease.
Definition: What is cervico-brachial neuralgia?
Cervicobrachial neuralgia refers to a pain which spreads from the neck to the upper limbs of the body. It is also known as “neck sciatica” or “arm sciatica”.
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, cervico-brachial neuralgia 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.
Cervicobrachial neuralgia, an occupational disease?
Le computer work is an important cause of neck pain (including cervico-brachial neuralgia). Indeed, this condition is very common among people with a sedentary job. In addition, pain can also occur due to professional activities exposed to vibrations, repeated movements, or heavy lifting.
Over time, stiffness and pain appear and intensify. Performing daily tasks then becomes more difficult.
Currently, cervico-brachial neuralgia is not recognized as a occupational disease. Moreover, the same is true for the cervical hernia. Thus, the person suffering from this disease is not compensated at all.
If the symptoms lead to a partial or complete inability to carry out their professional duties, it is advisable to discuss with their attending physician and their employer the possible alternatives (such as for example a work stoppage, a professional redeployment or a statement of work-related illness).
In the meantime, here are some tips that will help you treat and prevent this disease if you think it is work-related:
- When you are at the office: try to organize your workspace well, and avoid prolonged static postures as much as possible. Try to straighten your back using the exercises and advice presented in this article.
- When working on your computer: make sure your computer screen is at the same height as your eyes. Thus, you will not have to constantly lower or raise your head. On the other hand, it must be understood that the frequent change of position is the best way to prevent the appearance of dysfunctions, even more so than adopting a straight posture.
- During your sleep: choose a good pillow (ideally shape memory) to support the cervical spine.
- Avoid carrying loads that are too heavy and repetitive.
- If you have no choice, at least be sure to improve the strength and stability of your neck and upper extremities to meet the physical demands of your job.
- Find ways to manage your stress which is notably responsible for muscle tension and linked to the appearance of neck pain.
Causes: What causes cervico-brachial neuralgia?
La cervico brachial neuralgia 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.
Several factors are at the origin of cervico-brachial neuralgia. It may be due to a cervical spondylosis, or in the most frequent case, to a cervical hernia.
Also called cervicarthrosis, cervical osteoarthritis appears quite early. It is quite common in people reaching their forties and the elderly.
To know everything about cervical osteoarthritis and its management, see the following article.
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.
Sometimes the diameter of the foramen (the hole through which the nerves pass) is reduced. This occurs in the presence of cartilage wear, disc degeneration, of a codiscarthrosis, or narrow lumbar canal.
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 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.
Besides the causes mentioned above, there are other conditions potentially responsible for cervico-brachial neuralgia. The tumor, heredity, a fracture at the cervical level, or a malformation can also be at the origin of the cervicarthrose. In addition, cervico-brachial neuralgia can be related to pregnancy, muscle contracture, or even a Scoliosis.
To know everything about cervical hernia and its treatment, see the following article.
Other causes of cervico-brachial neuralgia (most of which are rare) include:
- Tumors et cancer
- Trauma (such as a fracture of Jefferson, the odontoid or vertebrae)
- Narrow lumbar canal
- Infection (such as spondylodiscitis)
- And many more functions
Symptoms of cervico-brachial neuralgia
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 of cervico-brachial neuralgia
Le health professional (such as a family doctor, rheumatologist, orthopedic specialist, etc.) is able to diagnose cervicobrachial neuralgia. 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 symptoms of cervico-brachial neuralgia.
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) examinations 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.
Le 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 cervicobrachial neuralgia?
La cervico brachial neuralgia is a condition that should not be overlooked, especially when the pain persists and limits daily activities.
Here is a list of treatments (not exhaustive) to relieve cervico-brachial neuralgia. Obviously, natural treatments should be prioritized to avoid invasive procedures such as infiltration or surgery.
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.
To learn all about the role of medication in back pain, see the following article.
heat and ice
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 a neck brace, this 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.
Although not supported by solid scientific evidence, several alternative treatments are used to relieve symptoms and treat cervico-brachial neuralgia. Among the methods used are:
- suction cup
- acupressure mat
- Quinton plasma
- percutaneous hydrotomy
- therapeutic yoga
- craniosacral therapy
Used in homeopathy and naturopathy, natural products include non-pharmacological products such as essential oils, natural ointments, food supplements, etc.
To learn all about natural products (and which ones to use), see the following article.
Spinal cortisone injections
In this practice, cortisone is injected into the affected vertebral level to reduce the inflammatory process responsible for the symptoms. It is used when medication and rehabilitation does not provide significant relief.
To know everything about infiltrations in the treatment of back pain, see the following article.
Le surgical treatment
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.
Possible operations include:
- Cervical arthrodesis
- Discectomy et microdiscectomy
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.
How to sleep with cervico-brachial neuralgia?
As mentioned previously, it is possible that the symptoms refer to the head and cause headaches in the presence of cervicobrachial neuralgia. If the cervical region is painful on palpation, it may be appropriate to use a silk pillowcase. Indeed, the silky texture could reduce the irritation and discomfort of the head on the pillow.
Besides the texture of the pillow, another essential element is the support of the cervical region during sleep. It is essential to find a pillow that fits the cervical curves well in order to avoid extreme positions that could aggravate the symptoms. In general, we recommend a orthopedic pillow shape memory that offers good results in many patients.
To know the physiotherapist's opinion on the memory foam pillows (including recommendations), see the following article.
As for the sleeping position, it is recommended to sleep on the side with the symptomatic arm at the top (for example, lying on the left side if the paresthesias affect the right upper limb). This avoids compression on the side of the pain, and greater freedom of movement of the affected arm. It is also recommended to place a pillow under the armpit on the affected side to provide more support to the shoulder and the scapular region.
Finally, placing heat in the cervical region before sleeping can help relax the muscles and improve the quality of sleep. We recommend 15 minutes with a heat pack before bedtime.
Prognosis: How long does cervico-brachial neuralgia 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 cervico-brachial neuralgia that lasts for more than 3-6 months is considered more difficult to treat, and will require a tailored treatment approach.
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.
When we have cervico-brachial neuralgia, 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 previously, certain prolonged postures can be a prelude to musculoskeletal disorders such as cervico-brahcial neuralgia.
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!
Cervicobrachial neuralgia is a condition that affects the quality of life of people affected. Neck pain that radiates into the arm, potentially associated with numbness and sensation of electric shock, defines the clinical picture.
The causes are multiple, and are related to irritation of the nerve roots emerging from the cervical spine. Cervical osteoarthritis and herniated disc are the most common causes of cervico-brachial neuralgia.
There are several strategies to relieve the symptoms of this disease. A healthcare professional will be able to guide you through this complex process, and prescribe solutions adapted to your needs and your condition.
Good recovery !
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