Brachialgia Causes, Risks, and Treatment. Is it like Sciatica?

What is brachialgia 

Brachialgia is a type of arm pain that is often associated with neck and shoulder pain. This arm pain is different from other types of arm pain as it affects the nerves. Other types of arm pain are due to muscles or bones. When the nerves that run along the arms through the neck and shoulders are damaged/pressed/pinched, etc, you get brachialgia, also called a cervical brachial syndrome.

Brachialgia is not a fatal disease. But it is a very painful and uncomfortable disease that could hinder your normal life. Getting it treated should be your priority. This article aims to shed some light on the details of the disease, which includes cause, diagnosis, and treatment. However, you must always consult a doctor for the assessment. No article on the internet can be as precise and helpful as a doctor’s consultation. 

This is what this article contains:

• What causes brachialgia 
• Which part of your body is affected and why 
• Possible risks of the disease
• Which doctor to consult 
• Treatments of brachialgia 
• Difference between brachialgia and sciatica 
• Conditions similar to brachialgia 

What causes cervical brachial syndrome?

The human body can feel things and do things because of little biological wires called nerves. These nerves emerge from the main central nerve called the spinal cord. The spinal cord is connected to the brain which is the hub of all processing functions. 

The nerves that emerge from different portions of the spinal cord travel to different parts of the body for the “wiring”. The collection of nerves that branch out from the spinal cord in the neck and shoulder region towards the arms is called the brachial plexus. This plexus has the brachial nerves and any damage/pinching in these nerves can cause brachialgia or cervical brachial syndrome. 

The details of brachialgia 

This section will go into detail about the structure of the vertebral column, the nerve roots in the spinal cord, and the possible causes of brachialgia. You can move to the next section if you wish to skip this. But it is always recommended to read the details to get more familiar with the condition.

The human vertebral column is made up of 33 hollow vertebrae. These are the bones you feel if you touch the middle of your back.  The vertebral column is divided into five sections; Cervical, thoracic, lumbar, sacral, and coccygeal. 

Vertebral section	Number of vertebrae
Cervical	7(separate)
Thoracic	12(separate)
Lumbar	5(separate)
Sacral	5 (fused)
Coccygeal	4 (fused)

These vertebrae have a cavity inside them, through which the spinal cord passes. This cavity is called vertebral foramen. Now let’s get on the nerves. 

Each of these vertebrae has spinal rami which are also called the nerve roots. This is where the peripheral nerves emerge and branch out to the body. Specific nerves are emerging from the vertebral column. The table shown below will show the number of nerves that emerge from these vertebrae. 

Vertebral section	Number of nerves
Cervical	8 nerves
Thoracic	12 nerves
Lumbar	5 nerves
Sacral	5 nerves
Coccygeal	1 nerve

Amongst all these nerves, brachialgia is concerned with only five nerves; C5, C6, C7, C8, and T1. This is four nerves from the cervical region and 1 nerve from the thoracic region. This collection is called the brachial plexus. Any damage to these nerves causes brachialgia or cervical brachial syndrome (now the cervical makes sense, doesn’t it?).

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How do the brachial nerves get affected?

Since these nerves emerge from the vertebral column which has a lot of joints, there is always a risk of some form of damage if the vertebrae are damaged. Some of the common causes of brachialgia are: 

• Osteophytes 
• Spinal stenosis
• Spinal disc degeneration
• Intervertebral disc displacement
• Spondylosis
• Vertebral damage 
• The unstable or weak vertebral column
• Ligaments overgrowth 

Here’s a brief explanation of what these terms mean. 

• Osteophytes – Also known as bony spurs, these are a tiny overgrowth of bones that occur when the bones are damaged. The damage causes a deposit of calcium to reinforce it. These spurs can pinch or press the brachial plexus.

• Spinal stenosis – Remember the cavity inside the vertebral column? When this cavity gets narrower, it is called spinal stenosis. This reduced space can cause nerve compression and hence, brachialgia. 

• Spinal disc degeneration – When the vertebrae get weak, brittle, etc due to mineral deficiency, they tend to slip or displace ( also called intervertebral disc displacement). This can compress the nerve root. 

• Spondylosis – Spondylosis is the arthritis of vertebral bones caused by the wear and tear of the vertebral discs.

• Vertebral damage – Damage due to shock, impact, etc can displace the discs or cause osteophytes which then impact the nerves.

• Ligaments overgrowth – Ligaments connect bone to bone. Sometimes, an overgrowth can compress the nerve in the spinal cord and cause brachialgia. 

Possible risks of brachialgia 

Brachialgia is a nerve disorder, caused by the physical compression of the nerve plexus. This occurs due to bone complications or physical damage. So you don’t have to worry about it other than the annoying pain it brings. 

Sometimes it could be due to some form of tumor or lesions, but that’s very rare. It is most probably because of some bone issues. But to make sure it is just brachialgia, you must look at the symptoms and the diagnosis. Again, looking at the symptoms on the internet is not advised and this article is meant to be an informative article, not a diagnostic one. Hence it is recommended that you should consult a doctor to make sure you get the best treatment.

Symptoms of brachialgia 

As mentioned above, brachialgia affects the brachial plexus that runs from the C5 to T1 of the vertebral column. This is your neck and shoulder region. So a persistent pain in these regions could be a sign of brachialgia. Apart from this, there are other symptoms as well. Here’s the list:

• Numbness in the shoulder and arm region
• Tingling sensation
• Persistent pain
• weakness in the arm
• Sensations of being pricked by needles
• Sometimes headaches are also associated with brachialgia

Diagnosis of brachialgia 

There is no definitive diagnosis of brachialgia and it is the symptoms that indicate a possible connection between the pain and the disease. Pain in the neck, shoulder, wrist, arm is a diagnostic sign of the condition. This accompanied by increased pain after arm activity and recurring pain at night reinforces the diagnostic. If these are the symptoms in your case, it is advisable to visit a neurologist. Here are the tests that would ensue after initial check-up.

• A general examination of the neck and shoulder region
• X-Ray of the neck and shoulder region to detect bone or ligament deformities
• If not detected, a possible MRI, or CT-scan for further investigation
• Angiography or venography to check if the blood vessels are affected or not.

The treatment of this condition depends on the extent and cause of brachialgia. If the pain and the pinching is not serious and is caused by bone displacement or ligaments, corrective exercises and medicines are given. In some serious conditions (where pain is immense), a surgery follows. This is usually in the case of osteophytes. Analgesics are the most common drugs that are prescribed to the patients.

Similar conditions

There are some conditions that are often confused to be the same or different condition than brachialgia. For example, cervical radiculopathy, brachial plexus syndrome, brachialgia are the same condition. Similarly, spondylosis is the arthritis of vertebral column and is not associated with brachialgia.

Another condition is the cervical myelopathy which occurs when the cervical vertebrae are compressing the nerves. This includes the C1 to C7 vertebrae. Spondylosis is the precursor to CSM (cervical spondylotic myelopathy). This means that the compression is due to the age-related degeneration (spondylotic) of the vertebral column.

Another similar condition is called sciatica and it is, in essence, the same disease just in a different region. Brachialgia occurs in the neck and shoulder region, the brachial plexus being affected by the C5 to T1 vertebrae. Sciatica is when the L4, L5, S1, S2, and S3 vertebrae compress the sacral plexus in the hip and leg region. This results in similar pain and tingling in the legs and hips. This is the difference between brachialgia and sciatica.

This was all associated with brachialgia. As mentioned before, you must always consult a doctor to get the proper diagnostic. This article is just to be informative about the possible disease.