Cervicobrachialgia or cervical radiculopathy

What is cervicobrachialgia or cervical radiculopathy?

Cervicobrachialgia refers to pain that starts in the neck and radiates into the arm. This pain may be accompanied by numbness, tingling, or weakness in the arm. It is a specific form of neck pain that involves nerve irritation.

What is the difference between cervicobrachialgia and radiculopathy?

In both conditions, you experience pain that starts in the neck and spreads down into the arm. The symptoms are often similar, but the terms have slightly different meanings.

We refer to radiculopathy when it's determined that one or more nerves in the neck are irritated or compressed. This is the more precise medical term that confirms nerve involvement.

The term cervicobrachialgia describes the symptoms (neck pain that radiates into the arm) without necessarily confirming that a nerve is compressed.

In practice, the two terms are often used interchangeably. What really matters is to properly assess the cause of your pain in order to treat it effectively.

What are the symptoms of cervicobrachialgia?

The clinical presentation varies from person to person. Often, but not always, you will feel pain or stiffness in your neck, shoulder blade area, or shoulder. The pain also radiates into one or both arms and can appear in different forms.

Common symptoms in the arm

In general, neck movements and certain arm movements trigger the pain. This is normal, as these movements can increase pressure on the irritated nerve.

Other possible symptoms

Some people may also experience:

• A loss of sensation in the arm or certain fingers
• A loss of strength in the arm
• A feeling of a "dead arm" or a very heavy arm

These symptoms generally indicate more significant nerve compression. If you experience them, consult a healthcare professional promptly.

Serious symptoms to watch for (red flags)

Severe symptoms are rare (less than 1% of cases). In most cases, although the pain can be very unpleasant, the condition responds well to the right treatment.

However, certain signs and symptoms should prompt you to seek immediate medical attention at an emergency room or with a doctor:

• Severe weakness or paralysis in one or both arms
• Significant or complete loss of sensation in one or both arms
• Recent loss of balance when walking
• New incoordination of the arms or hands
• New difficulties with bladder or bowel control
• Loss of sensation in the genital areas

If you experience any of these symptoms, seek immediate medical attention. These situations are rare but require urgent medical evaluation.

What causes cervicobrachialgia?

The pain is caused by the irritation or compression of one or more nerves in the neck. Several factors can lead to this nerve irritation.

Main causes

The progressive wear and tear of neck joints (like osteoarthritis) is the most common cause in people over 50. If you also have neck pain with stiffness, you might have developed a cervical stenosis, which is a narrowing of the canal where the nerves pass through. A cervical disc herniation can also cause these symptoms, especially in young adults. When the disc moves out of its normal position, it can directly compress a nerve. Our guide on cervical disc herniation explains this condition in detail. Irritation due to overuse is the most common cause. For example, after straining to lift something or after keeping your neck in a prolonged awkward position.

Frequent triggers

You can develop this condition gradually over several months or years. However, it can also start suddenly following:

• A significant effort (lifting a heavy load)
• Neck or head trauma (car accident, fall, impact)
• A sudden wrong movement of the neck

In some cases, people develop cervicobrachialgia after a whiplash injury that has not healed properly.

How is cervicobrachialgia diagnosed?

Diagnosis is based on your symptom history and a clinical examination. Your physiotherapist or doctor will ask you questions about:

• When the pain began
• What movements trigger the pain?
• Where exactly do you feel the symptoms in your arm?
• If you experience weakness or numbness

The clinical examination includes

The physical assessment will involve examining:

Additional tests

In some rarer cases, radiological examinations (X-ray, MRI, EMG) may be necessary to determine the extent of nerve involvement. These tests are not required in the absence of severe symptoms.

Rest assured: most cases of cervicobrachialgia can be diagnosed and treated without the need for medical imaging. A clinical examination by a qualified professional is usually sufficient.

When should you see a physical therapist?

You should consult a physiotherapist if you experience symptoms like those described above, or if your doctor has already ruled out any other causes for your pain.

You don't need to see a doctor before consulting a physiotherapist. If your condition requires a doctor's attention, your physiotherapist will be able to guide you.

Physiotherapy for neck pain is very effective for cervicobrachialgia. Treatments can reduce nerve irritation and quickly improve your mobility.

Physiotherapy Treatments for Cervicobrachialgia

Your physiotherapist will conduct a thorough assessment to determine why your nerve is irritated. This assessment looks at several key elements.

Elements Assessed by the Physiotherapist

Personalized Treatment Plan

Based on the results of the assessment, your physical therapist will:

• Mobilize the joints and nerves in your neck and arms to reduce pain and improve movement.
• Provide you with specific exercises to do at home to address the cause of the problem
• Teach you how to properly manage your daily activities to optimize healing
• Give you advice for your postural habits and movements

Nerve mobilization techniques (neuro-mobilization) are particularly effective for this type of condition. They help release a pinched or irritated nerve and can quickly relieve symptoms.

What to Do at Home to Relieve Cervicobrachialgia?

Temporarily stop movements that cause a lot of pain. Gradually resume them later, as the pain decreases.

Practical Tips for Home

Move your neck in movements that don't cause any pain. Movement helps with healing by maintaining circulation and preventing stiffness. Support your shoulders and shoulder blades to reduce tension on the nerves:

• With a cushion under the armpit
• With the armrests of a chair or sofa
• By putting your hand in your pants pocket while standing

Limit the time spent in the same position (computer, television, reading). Get up regularly for a few minutes to move your neck and shoulders. Make sure your neck is well supported when sleeping with a pillow that fills the curve of your neck. Sleeping on your stomach should be avoided, especially if you experience morning stiffness or pain.

If you do not see any improvement after 10 days, you should consult a physiotherapist.

Did You Know? Facts About Cervicobrachialgia

Cervicobrachialgia affects about 1 in 1000 people each year. It is more common between the ages of 50 and 54, but can occur at any age.

In 90% of cases, symptoms improve significantly within 3 months with appropriate treatment. This condition generally responds very well to physiotherapy.

The C6 and C7 nerves are most commonly affected, causing symptoms in the thumb, index, and middle fingers. Identifying the affected nerve helps guide treatment.

Surgery is rarely necessary, affecting less than 10% of cases. The vast majority of people recover completely with conservative treatment.

Related conditions to explore

If you suffer from neck pain radiating into your arm, other conditions could be related:

• Neck Pain: A Complete Guide to understanding the different causes of neck pain
• Cervical Disc Herniation if a herniated disc is suspected
• Cervical Stenosis if you are over 50 with osteoarthritis
• Cervical Sprain if you have recently experienced trauma
• Cervical Osteoarthritis to understand the wear and tear of neck joints
• Physiotherapy for Neck Pain to learn more about treatments

Book an appointment with a physiotherapist

If your neck and arm pain limits your daily activities or persists despite your efforts, our physiotherapists can help. A thorough assessment will identify the exact cause of your symptoms and develop a personalized treatment plan.

Book an appointment

References

• McCartney S, Baskerville R, Blagg S, McCartney D. Cervical radiculopathy and cervical myelopathy: diagnosis and management in primary care. British Journal of General Practice. 2018 Jan 1;68(666):44-6.

• Kuijper B, Tans JT, Schimsheimer RJ, Van Der Kallen BF, Beelen A, Nollet F, De Visser M. Degenerative cervical radiculopathy: diagnosis and conservative treatment. A review. European Journal of Neurology. 2009 Jan;16(1):15-20.

• Iyer S, Kim HJ. Cervical radiculopathy. Current Reviews in Musculoskeletal Medicine. 2016 Sep;9(3):272-80.

• Caridi JM, Pumberger M, Hughes AP. Cervical radiculopathy: a review. Hospital for Special Surgery Journal. 2011 Oct;7(3):265-72.

• Wong JJ, Cote P, Quesnele JJ, Stern PJ, Mior SA. The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature. The Spine Journal. 2014 Aug 1;14(8):1781-9.