Cervio – brachial pain
Cervico brachial pain is neck pain and stiffness linked with pain in the arm and shoulder. It happens due to a disorder of the spinal nerve root. This pain is Normally caused by a spinal disc herniation around the neck or other lesions that result in nerve root inflammation, impingement, or both.
Pain that goes from your neck-upper back area through to your arm-hand (upper limb) can be related to a compression of the nerve roots at the neck area of your spine, known as a cervical spine.
A herniated or protruded disk at the cervical spine, bone spurs or narrowing of the spine (spinal stenosis) can cause a compression of the nerve root (at the side part, in the foraminal space), affecting your upper limb, or even the spinal cord (at the central part of the spinal canal), affecting all the four limbs. This may lead to pain, numbness and sometimes weakness affecting the arm-hand, and rarely the whole body below the neck area. This kind of cervical disc disease can affect one or multiple discs at the same time.
Main risk factors for neck (cervical) problems include:
- Age: herniated disks caused at adult or older age, causing the typical neck with arm pain; but disc degeneration, bone spurs and cervical stenosis (narrowing of the spinal canal and/or foramen), which may happen pain, numbness and even weakness to one or both arms, are more common among older people.
- Smoking cigarettes: smoking cigarettes increases your risk of having disc disease.
- Lifestyle: it is suspected that twisting your neck and bad posture can lead to neck problem.
Signs & Symptoms:
Following are few neck problem related symptoms
- Pain that radiates from your neck through to your arm or hand can be related to a compression of the nerve roots at the neck (cervical) area of your spine.
- The pain may range from being quite mild to severe. Some people experience it like an electric shock.
- The pain is often aggravated by coughing, sneezing or moving the neck.
- Some people have numbness, tingling or weakness in the affected arm or hand.
At Al Biraa Clinic, a spine specialist will start to assess the patient with a medical history, physical exam, checking for muscle strength, sensation and reflexes. If necessary, imaging tests may be required. You may be asked to have an x-ray, MRI, CT scan and/or electroneuromyography (ENMG) for the proper diagnosis.
The spine specialist will give you a plan for your neck pain radiating to the arm and/or hand (cervical radiculopathy or myelopathy) treatment, according to the case, and cervical disc problem can affect one or multiple discs. This plan could include medications, such as: anti-inflammatories, painkillers and muscle relaxants, physical therapy, pain clinic and spinal injections.
If the patient does not improve with conservative treatment, spinal surgeon can proceed with the required surgical treatment to improve his neck problem due to cervical disc herniation, protrusion or related problem.
The main indications for surgery for cases of cervical disc problem, like disc herniation, bone spurs and stenosis, are the following: significant and persistent pain to the arm and/or hand, weakness of the upper limb, similar symptoms affecting the four limbs, and in more severe cases, loss of body movements (compression of the spinal cord). The spine surgeon usually uses a microsurgical technique to decompress the nerve and/or spinal cord, remove the affected disc, and replace the disc.
This kind of surgery is usually performed through the front part of the neck (left or right side), using an anterior cervical approach to remove the disc, replacing the injured disc using an artificial disc (arthroplasty) for motion preservation; or inserting a spacer to be fixed at the disc level, a fusion technique; or a combination of both, using a hybrid cervical surgery, in some cases of multiple levels.
There are other cases where the surgery is performed through the back part of the neck, for posterior decompression and fixation, according to the case.
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