Cervico-brachial or “sciatic neuralgia of the neck” manifests itself by pain that starts from the neck and radiates to the shoulder, arm or hand.
95% of cases of cervico-brachial neuralgia are due to hernia disc or osteoarthritis. It mainly affects young adults and those suffering from osteoarthritis.
Definition: What is a cervico-brachial neuralgia?
Cervico-brachial neuralgia is commonly called “sciatica of the neck” or “sciatica of the arm”. This is pain linked to compression or irritation of a nerve of the neck which extends along the arm. The pain affects the neck, the collarbone, the upper back, the shoulder and the arm, of one or both sides sometimes. The lesion at the origin of the Brachial cervico neuralgia is located at the level of the cervical vertebrae, in particular the 5th, 6th, and 7th cervical vertebra. Cervico-brachial neuralgia is one of the frequent causes of rheumatology consultation, after low back pain and lumbo-sciatica.
What are the causes of cervico-brachial neuralgia?
Cervico-brachial neuralgia is due to compression or irritation of a nerve root at the level of the cervical vertebrae. Among the most frequent causes:
► Cervical osteoarthritis
► Cervical hernia
► Trauma related to intense sporting practice,
► Cancer,
► a hematoma,
► an inflammatory mechanism,
► Viral infection,
► A hormonal imbalance,
► Mally balanced diabetes
► Intoxication …
► The hernia disc, corresponds to an abnormal projection of the intervertebral disc located between each vertebra, in the same way as that encountered during a sciatica.
What are the symptoms of cervico-brachial neuralgia?
Cervico-brachial neuralgia leads to pain which most often reaches young people and having no particular pathology. Pain can occur after a violent effort, such as by car during an accident (“rabbit”) or during a bad position. It is generally located on the side of a member but sometimes both sides can be reached. In some cases there is a partial loss of sensitivity in the fingers and/or arm. Depending on its location, pain leads to:
- tingling
- numbness
- Pain like electric discharges
- A feeling of heaviness in the shoulder blades or muscles of the trapeze which radiate towards the thumb or towards the fingers of the hand
- Headache
- dizziness
- Ear buzzing
- a limitation of neck movements.
Symptoms are generally present permanently, including at rest. Cervico-brachial neuralgia most often occurs in the form of a crisis which can be violent at night and at rest and are accompanied by a loss of muscle strength and a slight swelling of the arm.
How long does a cervico-brachial neuralgia last?
Cervico-brachial neuralgia may last several weeks or months in the absence of treatment. On the other hand, with suitable medical care, symptoms can be resolved in a few days or weeks.
The diagnosis of cervico-brachial neuralgia is a clinical diagnosis which is based on the precise interrogation of symptoms and a medical examination. A radiography of the cervical vertebrae, a scanner or an MRI can be carried out to search for the cause of the cervico-brachial neuralgia. In some cases an electromyogram highlights the damage of the nerve.
What treatment to relieve cervico-brachial neuralgia?
When demonstrating evoking a cervico-brachial neuralgia, it is important to consult a doctor quickly. In the meantime, it is recommended to put an analgesic to relieve pain. The patient can also wear a foam cervical necklace to rest the muscles of the cervical column. A hot hot water bottle on the neck and rest in the lying position on the back with a pillow, if possible ergonomic in order to respect the cervical curvatures, frequently relieve pain.
What drugs to take in case of cervico-brachial neuralgia?
Analgesics associated with anti-inflammatory drugs and muscle relaxants are generally prescribed for ten days. Sometimes morphine derivatives or corticosteroids are useful. A gesture of cervical corticosteroid infiltration under radiographic control or scanner can be proposed by a specialized rheumatologist or radiologist.
When to use physiotherapy?
Physiotherapy (massages, muscle strengthening, stretching) is useful if it is done with caution. It makes it possible to release the structures retracted by massages and muscle techniques aimed at freeing tensions, and to strengthen weakened muscles especially when the symptoms are old.
When to have surgery?
In the event of a failure of medical treatments, surgery can be appropriate in the event of the persistence of pain, prolonged incapacity to resume work and/or carry out the usual, daily or sporting activities. It is useful immediately in the event of engine deficit. However, it does not allow the disc to be repaired (the discharge lesions are irreversible) or to cure osteoarthritis. Thus the pain of the neck can be relieved only partially by the surgical intervention which especially makes it possible to restore muscle strength and dexterity.
Osteopathy, acupuncture: what are natural treatments?
Techniques such as osteopathy or acupuncture can be effective in relieving cervico-brachial neuralgia if there are surrounding muscle contractures, vertebral/costal blockages and collarbone for example. Thanks to its anti-inflammatory virtues, the peppermint essential oil brings powerful properties of local analgesic which help reduce the pain of nerve origin. Complemented with Roman chamomile oil which provides calming and relaxing properties, it helps to relax better. Finally, several homeopathic drugs can also help relieve certain symptoms such as Chamomilla 5 to 15 hp and Hypericum 9 to 15 hp for their action on pain and paraesthesia.
To prevent cervico-brachial neuralgia, pay attention to your posture by avoiding restrictive postures, on long periods like sitting for hours in front of a computer or on the phone. Also avoid traumatic sports such as the binding flow breaststroke for cervical, martial arts, fighting sports, or asymmetrical sports such as tennis. Prefer background sports, gymnastics, stretching or symmetrical sports.
Written and medically validated sheet by Dr. Claire Lewandowski, doctor specializing in general medicine.
