Cervicobrachial Neuralgia

27th November 2006 at 09:56 GMT by Dr.C.A.Jenner MB BS, FRCA. Permalink.

Article on the clinical features and treatment of Cervicobrachial Neuralgia

Introduction

Cervicobrachial Neuralgia is a syndrome associated with the inflammation of the brachial plexus. The term ‘cervicobrachial’ means relating to the neck and arm, while the term ‘brachial neuralgia’ generally refers to the pain associated with brachial plexus injury.

The brachial plexus is an arrangement of nerve fibers (a plexus) running from the spine, through the neck, the axilla and into the arm. All the nerves of the arm stem from the brachial plexus. Hence, lesions of plexus can lead to a severe functional impairment.

The term ‘neuralgia’ describes a variety of painful conditions in which shooting, stabbing, burning pain, electric-like shocks, tingling and feelings of pins and needle co-exist. The pain is normally brought on by an irritation of or damage to a nerve. Such pain is normally brief but may be quiet severe.

In simple words, cervicobrachial neuralgia is the pain in the neck radiating to the arm, due to compression of nerve roots of the cervical spinal cord.

Key Symptoms

Some of the typical symptoms and features of cervicobrachial neuralgia include:

• Severe pain in the shoulder region
• Muscle weakness
• Loss of sensation in the upper extremity
• Severe nocturnal pain

Some of the associated conditions include virus diseases, immunization, surgery and heroin use. However, the most frequent sequela is a painful neck.

Causes and Risk Factors

Research indicates that individuals with existing signs of depression and anxiety are at a higher risk of developing cervicobrachial neuralgia.

Besides, a vast number of studies also indicate towards the association of cevicobrachial neuralgia with tendonitis of the upper limb. Algodystrophy of the shoulder is also frequently observed.

In addition, cervicobrachial neuralgia is often considered to be associated to the compression of a nerve root. Another series of studies reported vertebral artery loop formation to be a rare cause of cervicobrachial neuralgia. An accurate CT scan normally confirms such diagnosis.

The condition can be congenital or acquired. If left untreated, the syndrome usually lasts for several months and sometimes even a year. Recurrences have been observed in a very few cases.

Refractory Cervicobrachial Pain (RCBP)

RCBP, an associated condition is a common syndrome in an occupational context. It is characterized by a widespread neck, shoulder girdle and arm pain, often of dysaethetic quality.

The sensation is accompanied by burning, associated with paraesthesia, impaired perception of touch, allodynia, hyperalgesia and hyperpathia.

Treatment of Cervicobrachial Neuralgia

Apart from medications, surgical decompression is also one of the preferred methods in a majority of cases.

Besides, chiropractic care has been found to be extremely helpful in patients diagnosed with cervicobrachial neuralgia. Properly planned physiotherapy regimens are also recommended in some cases. Alternate therapies such as homeopathy have proven to be result-oriented.