Cervicobrachialgia
| Classification according to ICD-10 | |
|---|---|
| M53.1 | Cervicobrachial syndrome |
| ICD-10 online (WHO version 2019) | |
Cervicobrachialgie (Latin / Greek for neck and arm pain; synonyms Cervicobrachialsyndrom, cervicobrachiale neuralgia, shoulder-arm syndrome, shoulder-arm syndrome and cervikobrachiales syndrome) hot from the cervical spine outgoing pain that radiates into the arm.
causes
The possible causes of cervicobrachialgia are manifold, the search for it is therefore interdisciplinary.
Degenerative changes in the cervical spine ( spondylosis , spondylarthrosis or uncovertebral arthrosis ) and herniated discs or segmental movement disorders , for example after a whiplash, are classic reasons. But also neurological diseases such as the tumorous infiltration of the brachial plexus , the carpal tunnel syndrome , neurogenic muscle atrophy , the complex regional pain syndrome , syringomyelia , neoplastic meningiosis , neurinomas of the cervical nerve roots, the chiralgia paraesthetica (pressure damage to the superficial ramus plexus), traumatic nerve damage , the neurovascular compression syndrome of the thoracic inlet ( engl. thoracic outlet / inlet syndrome, TOS / TIS) and the whiplash injury must be considered. The syndrome can be a challenge in terms of differential diagnosis, particularly due to its manifold possible causes .
Diagnosis
In addition to the clinical examination, diagnostic imaging methods such as MRI or CT are recommended.
therapy
Treatment depends on the causal disorder or damage. Degenerative changes cannot be treated meaningfully, but the pain they cause can. In terms of medication, painkillers can be used here , but also medication for muscle relaxation. With the tetrazepam , the industry offers a tranquilizer that belongs to the same substance class as the other benzodiazepines . The European approval of tetrazepam has been suspended since August 1, 2013, so it cannot be prescribed. The same precautionary measures should apply here as for all other drugs in this group.
A dubious method in the cervical spine is local infiltration . Studies have shown that no long-term improvement can be achieved in this way. The benefits of acupuncture do not exceed the placebo effect either.
The physical therapy with the goal of muscular stabilization of the cervical spine is very important. However, it must be ensured that the treating therapist does not continuously intervene with chirotherapy - this should be left to a suitably trained doctor. Physiotherapy in an acute state of pain is mostly pointless, however, the pain felt makes it impossible to strain the muscles of the cervical spine so much that a training effect could be achieved. First of all, adequate pain relief should be provided with which a therapeutic access is created.
Warmth is very effective. It is possible to prescribe massages and hot air.
Prescribing stabilizing foam collars is problematic. The muscles of the cervical spine are less stressed by this collar and lose strength; In the long run, such treatment worsens the clinical picture.
Intervertebral disc operations make sense if there have been severe failures in the nerve supply. The pain-therapeutic benefit of these interventions is usually disappointing.
Individual evidence
- ↑ P. Reuter: Diagnosis & therapy. Bohn Stafleu van Loghum, 2009, ISBN 978-90-313-6030-7 , pp. 55, 156, 254. (online)
- ↑ a b J. J. Martin: Neurology, practical huisartsgeneeskunde. Bohn Stafleu van Loghum, 2004, ISBN 90-313-3752-8 , p. 17ff. (on-line)
- ↑ JBM Kuks et al.: Clinical neurology. Bohn Stafleu van Loghum, 2007, ISBN 978-90-313-4633-2 , p. 200. (online)
- ↑ U. Moorahrend: Controversies on whiplash trauma: accident mechanics , initial diagnosis, neuroradiology, physical therapy, surgical indication. Birkhäuser, 2003, ISBN 3-7985-1383-X . (on-line)
- ^ Society of German Nerve Doctors, German Society for Neurology: German Journal for Neurology, Volume 185, Verlag F. C. W. Vogel, 1964, p. 453. (online)
