Cervicobrachialgia or cervical radiculopathy
In both injuries, there is pain felt in the neck that then radiates into the arm, or vice versa.
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What is cervicobrachialgia or cervical radiculopathy?
It is a condition where you have pain that starts in the neck and radiates down the arm. The pain may be accompanied by numbness, tingling, or weakness in the arm. It is a specific type of neck pain that involves nerve irritation.
What is the difference between cervicobrachialgia and radiculopathy?
In both injuries, you experience pain in the neck that then radiates down the arm (or vice versa). The symptoms are often the same.
It is referred to as radiculopathy if one or more nerves in the neck are determined to be irritated or compressed. This is the more accurate medical term.
The term cervicobrachialgia is used to describe 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 or radiculopathy?
There is often (but not always) pain or stiffness in the neck or in the shoulder blade and shoulder area. The pain also radiates into one or both arms and may manifest as:
- Electric shocks (sensation of a shock in the arm)
- Tingling or prickling sensation
- Pins and needles sensation
- Burning sensations
In general, neck movements and certain arm movements trigger the pain. This is normal, as these movements can increase pressure on the irritated nerve.
Some people may also experience other symptoms such as:
- A loss of sensation in the arm or certain fingers
- A loss of strength in the arm
- Feeling as though your arm is numb or very heavy
To better understand anatomy and why these nerves can become irritated, see our guide tocervical anatomy.
What are the serious symptoms of cervicobrachialgia or radiculopathy to watch out for?
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 the emergency room or from a doctor. These include:
- Severe weakness or paralysis of one or both arms
- Significant or even 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 or when wiping after a bowel movement
If you have any of these symptoms, don't delay. Seek medical attention immediately.
What causes cervicobrachialgia or radiculopathy?
The pain is caused by irritation or compression of one or more nerves in the neck. Irritation or compression of the nerve may be caused by:
- Progressive wear and tear of the joints in the neck (such as osteoarthritis). This is the most common cause in people over 50. If you also have neck pain with stiffness, you may have developed cervical stenosis (narrowing of the canal where the nerves pass).
- A herniated disc (quite rare and mainly affecting young adults). When the disc slips out of place, it can directly compress a nerve. See our guide on cervical herniated discs for more details on this condition.
- Irritation of the joints, muscles, or nerves in the neck due to overexertion (this is the most common cause). For example, after straining to lift something or after keeping the neck in an awkward position for a long time.
You may develop this injury gradually over several months or years. But you can also trigger the injury suddenly as a result of:
- 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.
10 mini-tips to understand your pain
Those who have had the greatest impact on my patients' lives. 1 per day, 2 min.
How is cervicobrachialgia or radiculopathy diagnosed?
The diagnosis is made based on your symptom history and a clinical examination. Your physical therapist 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 will include tests to assess:
- The mobility of your neck
- The sensitivity of your arm and fingers
- The strength of your muscles
- The gliding of your nerves
In some rare cases, it is necessary to undergo radiological examinations (X-ray, MRI, EMG) to determine the extent of nerve damage. These examinations are not necessary if there are no serious symptoms.
Rest assured, most cases of cervicobrachialgia can be diagnosed and treated without the need for medical imaging.
When should you see a physiotherapist for cervicobrachialgia or radiculopathy?
You should consult a physiotherapist if you have symptoms as described above, or if your doctor has already ruled out any other cause for your pain.
You do not need to see a doctor before consulting a physiotherapist. If your condition requires medical attention, your physiotherapist will be able to tell you.
The good news is that physical therapy for neck pain is very effective for cervicobrachialgia. Treatments can reduce nerve irritation and improve your mobility.
What physiotherapy treatments are available for cervicobrachialgia or radiculopathy?
Your physical therapist will perform an assessment to determine why your nerve is irritated. To do this, he or she will evaluate the following:
- Your joint mobility (how your vertebrae move)
- Sliding your nerves (to see if they are pinched or irritated)
- Your postural habits (how you hold yourself on a daily basis)
- The quality of your movements (how you move your neck and arms)
- Your strength and stability (are your muscles strong enough to support your neck?)
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.
- Give you specific exercises to do at home to address the cause of the problem and relieve pain
- Teach you how to properly manage your daily activities and hobbies 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 to release the trapped or irritated nerve.
Need professional advice?
Our physical therapists can assess your condition and offer you a personalized treatment plan.
Book an appointmentWhat can you do at home for cervicobrachialgia or radiculopathy?
Stop doing movements that cause too much pain temporarily. Gradually start doing them again later, when the pain subsides.
Here are some other tips that can help at home:
- Move your neck in movements that do not hurt at all.
- Support your shoulders and shoulder blades:
- 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 a little.
- Ensure your neck is well supported when sleeping at night with a pillow that fills the hollow of your neck. Sleeping on your stomach should be avoided, especially if you experience stiffness or pain in the morning or during the night.
If you don't see any improvement after 10 days, you should consult a physiotherapist.
Need help with your neck and arm pain?
If your neck and arm pain limits your daily activities or persists despite your efforts, our physical therapists can help. Visit our neck pain page to learn more about our services and make an appointment at one of our clinics.
Did you know?
- Cervicobrachialgia affects approximately 1 in 1,000 people each year.
- It is most 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.
- The C6 and C7 nerves are most commonly affected (causing symptoms in the thumb, index finger, and middle finger).
- Surgery is rarely necessary—less than 10% of cases.
Sources
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.
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