OrthoNeuroSpine & Pain Institute
What is brachialgia?
Brachialgia is a technical term for arm pain. It is generally used when the pain is thought to be due to a problem with the nerves, most frequently a compressed or pinched nerve in the neck.
How does brachialgia occur?
The spinal canal and intervertebral foraminae are bony tunnels in the spine through which run the spinal cord and spinal nerves (nerve roots) respectively. When the size of these tunnels is reduced, there is less room for the spinal nerves and/or spinal cord, the consequence of which may be pressure on these structures.
Symptoms of neural (nerve or spinal cord) compression include pain in the neck, shoulder blade or arm. Numbness, tingling sensations, and weakness are often associated with brachialgia.
Disorders that can cause nerve root compression and brachilagia include spinal stenosis, degenerative disc disease, a bulging or prolapsed intervertebral disc, bony spurs (osteophytes), or spondylosis (osteoarthritis of the spine). Commonly, two or more of these conditions are seen together.
How is brachialgia treated?
There are a number of treatment options fro brachilagia, and these will depend upon your specific situation:
- Pain medications. A number of medications may be useful for pain. These include the standard opioid and non-opioid analgesic agents, membrane stabilising agents and anticonvulsants, as well as Pregabalin. Special medical treatments such as Ketamine infusions may be appropriate in some situations.
- Nerve sheath injections. Local anaesthetic may be injected through the skin of the neck, under CT scan guidance, around the compressed nerve. This is also known as a ‘foraminal block’. Patients frequently obtain a significant benefit from this procedure, and surgery can sometimes be delayed or even avoided. Unfortunately, the benefit obtained from this procedure is usually only temporary, and it tends to wear off after several days, weeks, or sometimes months. This procedure is also an excellent diagnostic tool, especially when the MRI scan suggests that multiple nerves are compressed and your neurosurgeon would like to know exactly which nerve is causing your symptoms.
- Physical therapies. These include physiotherapy, osteopathy, hydrotherapy and massage.
- Activity modification. Sometimes simply modifying your workplace and recreational activities, to avoid heavy lifting and repetitive neck or arm movements, allows the healing process to occur more quickly.
- Surgery. Surgical options include anterior cervical discectomy and fusion, foraminotomy, posterior cervical decompression (laminectomy) with or without fusion, and an artificial disc replacement.
Brachialgia is the medical term to describe a certain type of arm pain caused by a compressed or pinched nerve in the neck.
What causes brachialgia?
The spine has two bony tunnels that contain the spinal cord and the spinal nerves and when something happens to reduce the diameter of the tunnel/s the cord or the nerves become pinched. This pinching or neural compression causes several symptoms. These may include pain in the neck, shoulder blade or arm along with weakness and a numb, tingling feeling.
Brachialgia pain can be brought on by any of these conditions:
- Rigid spine - spinal stenosis
- Degenerative disc disease
- Bulging or slipped disc
- Excess bone growth causing bony spurs on the spine
- Osteoarthritis of the spine – spondylosis
- Accidents and sports injuries
It’s also quite common for two or more of these conditions to occur at the same time.
How is brachialgia treated?
After your doctor has diagnosed brachialgia, you’ll find there are quite a few treatments available to give pain relief and help the healing process. Depending on your individual requirements, these may include:
- Manipulation of the spine to relieve the compressed nerves
- Back massage to reduce pain and correct the compression
- Specially designed exercises to strengthen bones and abdominal muscles
- Gentle stretching Hydrotherapy to increase range of movement
- Posture improving exercises
Brachialgia from osteoarthritis of the spine often improves after a few sessions of physiotherapy designed to free the pinched nerve. In addition, warm water swimming sessions/hydrotherapy supervised by your physiotherapist often help to resolve this condition. Massage therapy is another treatment that can free trapped nerves, reduce pain and speed up the healing process.
Pain medication is a commonly recommended medical treatment and you may be prescribed powerful painkillers, membrane stabilising drugs and anti-convulsants. In some cases, medical treatment may require Ketamine to be given through an I.V. drip in the arm.
Nerve sheath injections may be necessary to block pain and nerve spasms. This is a local anaesthetic injected into the neck around the compressed nerve. This greatly improves brachialgia and surgery can sometimes be delayed or even avoided. Unfortunately, the benefit of these injections is only temporary and wears off after several days or weeks.
Severe cases of brachialgia may need surgery and if you have the common symptoms – see a doctor for a correct, medical diagnosis.