What is cervico-brachial neuralgia?
Mini-lesson in medicine. The nerves that carry information from the brain to the arm, hand and fingers originate in the spinal cord, inside the spine. Their mixed roots emerge from the spine through the mating hole, a “bone gate”, and then progress up the neck. A little before the shoulder, the nerves differentiate before continuing their journey to the tips of the fingers.
The cervico brachial neuralgia is defined as irritation or damage to the root of a nerve that runs down the arm. Characterized by intense pain, cervicobrachial neuralgia is observed mainly at the level of the C5, C6, C7 and C8 nerve roots. The lesion or irritation takes place between the exit of the spinal cord and the exit of the spine (through the conjugation hole, therefore), ie over a portion of 2-3 centimeters.
What are the causes of cervicobrachial neuralgia?
There are two main causes (they represent about 95% of cases) that can lead to cervicobrachial neuralgia: herniated disc and osteoarthritis.
- In case of herniated disc, an intervertebral disc (these fibrous “plates” located between the vertebrae of the spine which prevent bone friction) can shift back and compress the nerve roots.
- In case of’arthritis, the conjugation hole (which therefore constitutes the “exit door” of the nerve roots) narrows due to osteoarthritis: this results in nerve compression.
And also. More rarely, cervicobrachial neuralgia can result from a tumor of the nerve root (neuroma), a tumor of the meninge (meningioma) or even a bone disease (bone metastases, for example) .
Cervico-brachial neuralgia: what are the symptoms?
To know. Cervico-brachial neuralgia affects both men and women and young populations are not excluded. People who practice physical trades (parachuting …) and / or sports that place a lot of strain on the spine (rugby …) are however more at risk of developing cervicobrachial neuralgia during their lifetime.
The number 1 symptom of cervicobrachial neuralgia is pain. This is intense, continuous and violent: it prevents sleep and makes each movement of the arm, hand and / or fingers painful.
It’s about a neuropathic pain, therefore of the electric type: one has the impression of having an electric current which leaves the neck and which goes down along the arm. This pain can also take the form of sensations of tingling, tingling, burning, hot or cold …
Diagnosis and treatment: what treatment for cervico-brachial neuralgia?
Because it is very painful, cervicobrachial neuralgia is most often an urgent reason for consulting a doctor. The diagnostic is essentially clinical: the patient describes his pain and precisely indicates its course so that the doctor can determine which nerve root is irritated or damaged (C5, C6, C7 or C8).
The doctor then looks for severity criteria which could reveal severe damage to the nerve root: muscle paralysis or a “sleeping” upper limb, for example. If severe cervicobrachial neuralgia is suspected (that is to say: with a really damaged nerve root, not only irritated), an electromyography (EMG) may also be performed.
The cause of cervicobrachial neuralgia is usually identified using an MRI scan or a CT scan of the spine.
Cervico-brachial neuralgia: what are the treatments? When cervico-brachial neuralgia is not accompanied by any criteria of severity, treatment is mainly symptomatic. Thus, the doctor will prescribe:
- painkillers. “Classic” analgesics (such as paracetamol) are generally insufficient: it will be more of gabapentin (Neurontin®) or pregabalin (Lyrica®).
- anti-inflammatory drugs. Against cervico-brachial neuralgia, powerful corticosteroids will be used.
Treatment for cervicobrachial neuralgia is often long, with unpleasant sensations in the arm that may persist for 3 months. Rest is absolutely essential, and a neck brace may also be prescribed – physiotherapy may also be indicated. Surgery, meanwhile, is exceptional and reserved for severe cervico-brachial neuralgia (a very large hernia threatening the spinal cord, for example).
Thanks to Dr. Jean-Pierre Balagué, neurologist at the Pont de Chaume clinic (Montauban – ELSAN group).
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