Do you have pain in your neck and arms? Find out if these types of pain are related.

If you have pain in your neck and your arms, you may be surprised to learn that they may be related to the same cause. When a person has both of these symptoms, it can be indicative of a condition in the cervical spine called cervicobrachialgia. This is the medical term for pain that originates in the cervical region of the spine and radiates down one or both arms, often due to compression of a nerve root or the spinal cord. However, not all cases of neck and arm pain are due to pathology in the cervical spine.

What causes neck and arm pain?

Pain in one or both arms can be a symptom of an issue with the cervical spine, especially when it occurs along with discomfort in the neck. However, pain in the neck and arms can have various possible origins, including:

1. Cervical radiculopathy

Cervical radiculopathy, also known as a pinched nerve, occurs when a nerve root in the cervical spine is compressed or trapped, leading to specific symptoms depending on which nerve root is involved. These symptoms can include pain in different areas of the arm (brachialgia), sensations such as tingling or a feeling of numbness, or even weakness in the muscles when moving the arm. The reasons for nerve compression can be varied, such as degeneration of the vertebral joints, disc herniations, or even vertebral infections or tumors.

2. Cervical spondylosis

Cervical spondylosis, or osteoarthritis of the cervical spine, is a natural degenerative deterioration of the vertebral bodies due to causes such as age, genetics, smoking, a sedentary lifestyle, and poor posture habits. It causes stiffness, chronic pain, and can contribute to compression of the cervical nerve roots.

3. Disc disease, protrusion, and herniation of a cervical disc

The degeneration of an intervertebral disc in the cervical spine can exert direct pressure on a nerve root or the spinal cord, causing neck pain that radiates to one or both arms, and a feeling of tingling or change in sensation in different parts of the arm (usually the hands), and in its most severe stages, loss of strength in the arms or hands. These symptoms are often worsened by moving the neck.

4. Myofascial pain syndrome

This manifests as pain located in the neck and upper part of the thoracic spine, with specific trigger points that intensify the pain when pressed. The pain usually radiates to both shoulders, but does not affect the arms. It does not usually present altered neurological function.

5. Thoracic outlet syndrome

This is a rare condition caused by compression of the nerves at the upper outlet of the rib cage, caused either by an extra cervical rib or neurovascular compression in the cervical muscles or collarbone. Symptoms include pain, weakness, or sensory alterations in the arm, especially when changing the position of the neck or when moving the shoulder.

6. Rotator cuff syndrome

Rotator cuff syndrome refers to any injury, disease, or degenerative condition that affects the tendons and muscles that stabilize the shoulder joint. This syndrome is usually caused by inflammation, tearing, or compression of these tendons, resulting in pain and limited shoulder mobility. It is considered an occupational disease or injury, as it is often closely related to repetitive arm movement, muscular overload, work injuries, or aging (tendon degeneration). Symptoms include shoulder pain that can radiate to the upper arm or neck, a feeling of muscle weakness, and the inability to move the shoulder in severe cases.

Treatment for cervicobrachialgia

Treatment for neck and arm pain is determined according to the severity and origin of the symptoms and whether or not there is nerve involvement. In the vast majority of cases, a combination of rehabilitation and active physical therapy yields excellent results. A treatment plan that includes specific stretches and personalized exercises can significantly relieve neck pain and improve the patient's quality of life.

If conservative treatment with rehabilitation does not provide relief, there are some minimally invasive procedures available, such as:

• Cervical rhizolysis using pulsed radiofrequency: A technique that uses pulses of radiofrequency energy to relieve pain by modulating the affected nerves. It is aimed at improving neck pain when there is little arm involvement.
• Epidural infiltration of corticosteroids: An effective procedure for relieving neck pain by reducing inflammation and relieving pressure on nerves.

In cases where the previously mentioned conservative and minimally invasive treatments are not effective, or when the symptoms are severe, especially in cases where there is significant nerve involvement, it may be necessary to resort to surgery in order to relieve the pain.

• Surgical options include:
  • Cervical arthroplasty: This procedure consists of removing the damaged disc and replacing it with an artificial disc, allowing mobility of the spine to be conserved. This is best suited for patients who do not have significant degeneration of the vertebral joints.
  • Anterior cervical arthrodesis: In this procedure, the affected vertebrae are attached to each other by means of a fixation device, stabilizing the affected area.
  • Endoscopic cervical foraminotomy: Indicated mainly for patients who predominately suffer arm pain due to nerve involvement, with little neck pain. Currently, this technique can be performed endoscopically. This minimally invasive approach is an improvement over the traditional procedure because it avoids damage to the cervical muscles that which could cause residual pain after the surgery.
  • Posterior cervical laminoplasty or laminectomy: When involvement of the cervical spinal cord does not allow an anterior approach, through the front of the neck, the release of the spinal cord can be performed by creating space in the posterior region. This is done by modifying the anatomy of the vertebrae and freeing the compressed cervical cord.

The goal of these procedures it to provide relief from the symptoms, restore functionality, and prevent future complications

Why is it important to identify the exact cause of the pain?

Ascertaining whether the pain originates from a cervical nerve root, another cervical pathology, or some other condition, is essential for determining the most effective treatment, and to avoid misdiagnoses that could lead to unnecessary surgery.

Instituto Clavel, specialists in pathologies of the spine

At Instituto Clavel, we have a team of neurosurgeons, traumatologists and orthopedic surgeons specialized in the treatment of spinal pathologies.

We are experts in treating back pain and the other symptoms that usually accompany it.

In addition, we have a dedicated Pain Clinic, and we always work in coordination with our team of physical therapists and trainers.

There are effective treatments for arm and back pain that can provide relief from symptoms and minimize its impact on your daily life.

If you suffer from any type of back pain, we encourage you to make an appointment us at our centers in Barcelona or Madrid.

Dr. Iván Zabaleta Carvajal

Neuroseon
Specialist in minimally invasive approaches to the spine, surgery for tumors of the brain and skull, hydrocephalus and chiari malformation.