Brachalgia (Arm Pain)
About
This common condition (brachalgia - slipped disc, prolapsed disc, herniated disc) is characterised by pain spreading down from the neck, through the shoulder down the arm into the forearm or hand. The pain is usually severe in the early stages and feels like an electric shock in the arm. It may be made worse by coughing or sneezing. It is often associated with altered arm or hand.
**If you develop severe pain in both arms, difficulty in passing urine, incontinence, or loss of sensation around your genitals, then you should attend your nearest A&E department as a matter of emergency**
Treatments:
- Gentle exercise and simple analgesia (ibuprofen)
- Physiotherapy
- Nerve root injections
- Anterior cervical discectomy and fusion ACDF
- Anterior cervical discectomy and joint replacement ACDA
- Cervical foramenotomy
Outcomes:
- 90% of patients improve following surgery, with the majority seeing complete resolution of their brachalgia
- A few patients will have a technically successful operation but continue to have symptoms due to persisting nerve injury
- A few patients will go on to develop scar tissue or a recurrent disc prolapse, causing recurrent symptoms which can be difficult to manage
The most common cause of brachalgia is a prolapsed cervical disc. This occurs when the soft gelatinous centre of the disc ruptures backwards to squash the nerves in the neck. This may require surgery – see treatments - fusion or joint replacement.
Other causes including ‘wear and tear’ degenerative arthritic disease in the joints and ligaments of the spine may cause narrowing around the nerves. This may require surgery (cervical foramenotomy – or injection therapy.
In addition to an outpatient assessment and examination you may require an MRI scan if your symptoms persist. (Most patients with a slipped disc will improve without surgical treatment within 6 weeks). An MRI scan is a powerful magnet that creates a picture of your spine without any radiation exposure. The scanner is a long tunnel. The modern scanners now available are less narrow and do not cause claustrophobia for most patients. It is still fairly noisy during the scan however as the magnet clicks on and off.
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