Top Doctors recently had the pleasure of speaking with highly esteemed London-based consultant neurosurgeon, Mrs Anne Mitchener. Here, the mightily experienced doctor explains how exactly brachialgia is diagnosed, what the main symptoms are, and reveals the most effective treatment options.
What are the symptoms of brachialgia?
Brachialgia is pain in the arm and usually arises from the spine in the neck, the cervical spine.
How is brachialgia diagnosed?
We take a history of the pain, and then we thoroughly examine the arm, looking for signs such as weakness, numbness, and altered reflexes. We inevitably request either an MRI scan or a CT scan. They both give us a good definition of the tissue structures. We need to carry out one or the other in order to see if there is something impinging the nerve.
What are the causes?
It is usually caused by impingement of a nerve in the spinal cord in the neck. This can be caused by ligament thickening, a disc or herniation prolapse, and also potentially due to the facet joints at the back of the spine degenerating, twisting, and taking up space in the spinal canal.
How can it be treated?
We usually try to combine medication with physiotherapy at an early stage to see if this helps. Quite often when patients come to see us, the pain is quite severe, so they are receptive to the idea of a steroid injection, which is injected around the nerve in the neck.
Most patients can expect a reduction in pain within a few days of the injection. The alternative is to decompress the nerve surgically, but that is a final choice.
How effective is surgery as a treatment option for brachialgia?
Surgery is extremely effective when it comes to treating brachialgia. Pain relief is pretty much a guarantee following surgery. Surgery can be performed at the front or the back of the neck.