Also known as cervical radiculopathy or trapped nerve in the neck. Brachalgia is due to pressure on the nerves that branch out from the neck and travel down the arms.
It can be due to either a prolapsed disc in the neck or as a result of ageing and the wear and tear process (spondylosis, arthritis) resulting in a narrowing in the channel through which the nerves to your arms travel.
Brachalgia is characterised by neck pain, which spreads out to the shoulders and at times down the arm. It can be associated with numbness in the hand or arm and weakness again in the arm or hand. The pain can be very severe, there is often no trigger and people can wake up with the pain. In bad attacks there can be severe spasm in the neck causing it to be held in a twisted posture.
It is important to determine the cause of brachlgia especially if it is associated with significant pain, numbness or weakness in the arm or hand. You will need an MRI scan to establish the cause and severity of the condition.
Many attacks of brachalgia will improve with time, usually by 6 weeks.
Painkillers should be taken on a regular basis to provide effective relief and allow you to stay active. The condition is characterised by pain, inflammation and muscle spasm. A cocktail of medicines may be needed to address all the features of the problem. It is recommended to take a painkiller such as paracetamol, or codeine. If this does not help your doctor can prescribe stronger analgesics as needed. Also it is important to take an anti-inflammatory such as Ibuprofen and if there is marked muscle spasm a muscle relaxant such as diazepam. You will need to see your doctor who can tailor your drug treatment for the condition.
Patients can visit a physiotherpist, osteopath or chiropracter for this condition, in the early stages it can be too painful to have manipulative treatments.
In some cases injection of steroids into the inflamed nerve root can help relieve the symptoms.
Most cases of prolapsed disc will settle after 6 weeks. If the pain does not settle is difficult to control, is associated with significant weakness or numbness in the arms then surgery is an effective treatment.
Surgical treatment options are;
- Anterior cervical discectomy and fusion or disc replacement. In this operation the whole of the injured disc is removed via an incision in the front of your neck. The pressure on the trapped nerve to your arm is relieved. Once the disc has been removed the space is filled with either a device to fuse the vertebra or an artificial disc replacement. The device used depends on the degree of damage to the disc.
- Cervical foraminotomy. In this operation which is performed from the back of your neck. The opening in the spinal canal from where the nerves emeges to travel down your arm is made wider thus relieving the pressure on the trapped nerve.
Following surgery the pain will be completely resolved for the majority of patients. However, a few patients may still experience some symptoms if the damage to their nerves is irreversible. A very small number of patients may develop scar tissue at the site of the operation, which can cause recurrent symptoms.