Cervicobrachialgia or cervical radiculopathy

What is cervicobrachialgia or cervical radiculopathy?

Cervicobrachialgia refers to pain that originates in the neck and radiates down the arm. This 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 conditions, you experience pain that starts in the neck and radiates down the arm. The symptoms are often similar, but the terms have slightly different meanings.

Radiculopathy is the term used when one or more nerves in the neck are determined to be irritated or compressed. It is the more precise medical term that confirms nerve damage.

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 the neck, shoulder blade, or shoulder area. The pain also radiates into one or both arms and can manifest in different ways.

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
• The feeling of having a dead or very heavy arm

These symptoms usually indicate more severe 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 the emergency room or from a doctor:

• Severe weakness or paralysis of 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 irritation or compression of one or more nerves in the neck. Several factors can cause this nerve irritation.

Main causes

Frequent triggers

You may develop this condition gradually over several months or years. However, it can also occur 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.

How is cervicobrachialgia diagnosed?

The diagnosis is based on your symptom history and 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 includes

The physical assessment will examine:

Additional tests

In some rare cases, radiological examinations (X-ray, MRI, EMG) may be necessary to determine the extent of nerve damage. These examinations 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 physical therapist if you have symptoms as described above or if your doctor has already ruled out any other causes for your pain.

You do not need to see a doctor before consulting a physical therapist. If your condition requires medical attention, your physical therapist will be able to refer you to one.

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

Physiotherapy treatments for cervicobrachialgia

Your physical therapist will conduct a thorough assessment to determine why your nerve is irritated. This assessment examines several key elements.

Elements assessed by the physical therapist

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 the trapped or irritated nerve and can quickly relieve symptoms.

What can you do at home to relieve neck and shoulder pain?

Temporarily stop movements that cause a lot of pain. Gradually start doing them again when the pain subsides.

Practical tips for the home

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

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

Did you know? Facts about cervicobrachialgia

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. This condition generally responds very well to physical therapy.

The C6 and C7 nerves are most commonly affected, causing symptoms in the thumb, index finger, and middle finger. 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 may be related:

• Neck pain: a comprehensive guide to understanding the different causes of neck pain
• Cervical disc herniation if a herniation is suspected
• Cervical stenosis if you are over 50 years old with osteoarthritis
• Whiplash if you have recently suffered trauma
• Cervical osteoarthritis: understanding wear and tear on the joints in the neck
• Physical therapy for neck pain —learn more about treatments

Make an appointment with a physical therapist

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

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.