Cervicobrachial syndrome is pain in combination with neurological clinical symptoms that occurs against the background of cervical and cervicothoracic osteochondrosis. The muscles of the shoulders, shoulder girdles and free upper limbs are captured. The pain spreads to the fingers.
When symptoms of cervicobrachial syndrome appear, treatment should begin with the elimination of pathological degenerations in the area of intervertebral discs. The brachial plexus is responsible for the innervation of the muscles in this area. It is formed from branches of the radicular nerves extending from the 4th, 5th, 6th, 7th cervical and 1st thoracic vertebrae. The nerves responsible for the innervation of the shoulders, shoulder girdles and upper extremities depart from the plexus. The area of their innervation includes ensuring contractile activity of muscles and sensitivity of the skin.
The brachial plexus is divided into subclavian and supraclavicular branches. The first one goes to the armpit area, and the second one goes to the triangle in the neck area. As they move away from the plexus, the branches break up into trunks and branches.
As it develops, cervicobrachial osteochondrosis provokes compression of the radicular nerves, which form a plexus or pinching of branches extending from it due to statistical compensatory muscle tension in the neck and collar area.
Cervicobrachialgia can occur spontaneously or against the background of exacerbation of cervicothoracic osteochondrosis of the spine. This condition is characterized by:
- static muscle strain in the neck, collar area, shoulder girdle;
- compensatory tension of the tendon and ligamentous tissue, resulting in secondary compression of the radicular nerves;
- inflammatory swelling of soft tissues with increased blood supply to the area of the affected paravertebral tissue;
- pinching of the ulnar, radial, or median nerve leads to numbness of the fingers and weakening of muscle strength.
The appearance of a complex of inflammatory and neurological syndromes during the development of degenerative dystrophic disease of the intervertebral discs is due to a sharp decrease in their height and subsequent destructive processes. Nerve fibers can be affected in different areas, from the foramen in the vertebral bodies to tunnels deep in the muscle fibers.
At the initial stage, patients note discomfort in the shoulders and forearms after a day of work. Then persistent pain develops in the muscles of the collar area and shoulder girdle. The muscles are overstrained, spasmed and do not relax without outside intervention. This may be a consequence of compensatory tension in order to remove pressure from the nerve fiber or the result of inflammatory infiltrative edema against the background of increased blood microcirculation along the capillary bed. As pathological changes develop, pain spreads throughout the upper free limb.
In most cases, the syndrome is diagnosed in young active people aged 30 to 45 years. In later life, cervical-brachial syndrome rarely develops fully. More often, degenerative processes occur in the area of the glenohumeral joint of the bones.
If the symptoms described in the article appear, you should immediately consult a neurologist or vertebrologist. In Moscow, you can make an appointment at our manual therapy clinic. The initial consultation for each patient is completely free. During the appointment, the doctor conducts an examination and manual examination, as well as functional diagnostic tests. This allows him to make a preliminary diagnosis and recommend a plan for further examination. Individual recommendations for complex treatment are also provided.
Why does pain in the cervical spine radiate to the shoulder?
A healthy neck serves as a kind of reliable bridge between our torso and head. Anatomically, the basis (or supporting “rod”) of the neck is made up of seven vertebrae of the cervical spinal column, in the canal of which the spinal cord is located, and the five cervical vertebrae are separated from each other by elastic intervertebral discs (allowing us to tilt our heads).
Muscles and nerve fibers, arteries and veins also pass through the neck. Therefore, quite often “cervical” problems can affect both the muscles of the shoulder girdle and the bone structure of the spinal column in the cervicothoracic region.
In some cases (we will look at them below), pain in the cervical spine radiates to the shoulder if a person has some serious diseases, the diagnosis of which requires an immediate visit to the doctor, but sometimes this symptom occurs for fairly simple reasons:
- the neck may be exposed to a draft for a long time (for example, in the heat under an air conditioner or fan);
- the person slept in an uncomfortable position;
- there are postural disorders;
- due to muscle strain;
- the person has been exposed to stress for a long time, etc.
Exercise program for neck and shoulder muscles
The neck bears a heavy load, performing a huge range of functions. It is responsible for head movements and participates in other processes related to human physiology.
Causes of pain
Remaining in a sedentary state for a long time, the muscles of the cervical spine are subject to overstrain, which can lead to disruption of the outflow or flow of blood to the brain. As a result, a person begins to be bothered by seemingly causeless headaches, pain in the back and neck. Our neck consists of twenty-three muscles, which in turn form groups:
- Subcutaneous muscle of the neck;
- Sternocleidomastoid;
- Non-hyoid muscles;
- Hyoid muscles
- Lateral group;
- Medial group.
Modern medicine, not without reason, believes that it is easier to prevent a disease than to treat it. Therefore, for lovers of a sports lifestyle and in order to prevent discomfort among those who enjoy a sedentary lifestyle, it is recommended to engage in exercises to strengthen the neck muscles. Persons suffering from osteochondrosis of the cervical spine should approach exercises with caution and listen to their feelings. At the slightest sign of poor health, training should be stopped.
Exercises for athletes and people far from sports will be different.
Exercises to prevent osteochondrosis
Classes are aimed at relaxing the muscles of the neck and shoulders. Thereby preventing osteochondrosis of the cervical spine. It can be:
- Turns;
- Tilts;
- Stretching the neck muscles.
All exercises are performed in a sitting or standing position.
From a straight head position, we bend to the right and left, holding our head in the extreme position for a few seconds each time.
Turn your head to the right and left, trying to reach your chin to your shoulder, tilt your head forward, touch your chin to your chest.
Movement of the head in a circle, from the right shoulder to the left and back. After performing several movements, be sure to take breaks.
Turn your head to the side, while tilting your head back slightly.
Clasp your hands in a lock with straightened fingers, place your hands with your palms on your forehead, press your head against the lock, making light resistance with your hands. Then we weaken the resistance for a few seconds. Then press again.
We make the same lock, only now the hands are located at the back of the head. The principle is the same - we press our head on our hands. We alternate tension and relaxation.
Movements with the shoulders, while the palms are on the knees. We raise our shoulders up and gradually move them back, lower them and repeat the range of movements again.
Place your palms in front of your chest and press down on them, keeping your back straight. A few minutes of pressure, then relax your hands.
Exercises for athletes
The set of exercises for athletes differs from exercises for the prevention of congestion. For athletes, more attention needs to be paid to those muscle groups that are visible. To form a beautiful contour, you need to perform a number of activities that will help the athlete look harmonious and proportional.
In this case, more attention needs to be paid to two muscle groups:
- Sternocleidomastoid;
- Plaster-shaped.
The most common method of training does not require special equipment. The exercise is performed from a lying position on your back. You need to lie on a bench, head and neck free, feet firmly planted on the floor. The weight is placed on the forehead, neck flexion and extension are performed. To begin with, a weight of one or two kilograms will be sufficient. Flexion and extension are performed slowly. You can perform exercises to increase muscle volume with special equipment. To do this, use a weighting cable and various devices.
All exercises performed with weight-bearing devices should be performed under the supervision of experienced trainers.
Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
How often does pain in the cervical spine radiate to the shoulder? Who is in the “risk zone”?
According to statistics, this symptom is observed with equal frequency in almost half of all adults living on different continents and representing a wide variety of segments of the population (especially in people with long-term forced “sedentary” work or study). Moreover, it is more often registered in women than in men (with an approximate ratio of 3:2). Sometimes cases where pain in the cervical spine radiates to the shoulder also occurs in adolescents with poor posture and leading a sedentary lifestyle. By the way, it has been noticed that this symptom in most cases recurs again over the next five-year period.
A separate “risk group” for which the occurrence of this symptom is not uncommon consists of athletes who excessively engage in strength exercises with a barbell (especially on their own), contact wrestling, and swimmers.
Diagnostics
The diagnosis is made on the basis of an external examination of the patient, his complaints, a history of systemic diseases, and previous injuries. Cervicobrachial osteochondrosis is indicated by a bluish tint of the skin, swelling, and changes in the contours of the affected vertebrae. The most informative instrumental diagnostic method is radiography.
X-ray image of a patient with osteochondrosis.
Based on the obtained three-dimensional images, it is possible to determine with high accuracy the localization of the destructive-degenerative process, the stage of its course, the degree of damage to bone, cartilage tissue, and the ligamentous-tendon apparatus. Differential diagnosis is carried out to exclude arthritis, osteomyelitis, osteoporosis, arthrosis.
What diseases cause pain in the cervical spine to radiate to the shoulder?
Sometimes the cause of the development of this pain symptom can be quite serious factors of vertebrogenic (associated with pathologies of the spine) and non-vertebrogenic origin. It has been proven that only the “share” of glenohumeral periarthritis and other defects localized in the cervicothoracic spine account for almost 85% of all painful cases with a similar symptom (15% account for arthritis, arthrosis, somatic and oncological diseases).
Thus, if pain in the cervical spine radiates to the shoulder , this may indicate that the patient has:
- arthrosis of the shoulder joint (most typical for middle-aged and elderly people);
- rheumatoid arthritis;
- osteochondrosis;
- intervertebral hernia;
- plexitis;
- humeroscapular periarthritis;
- cervical spondylosis;
- myalgia;
- spinal canal stenosis;
- kyphosis, lordosis or scoliosis;
- shoulder injury;
- dislocated cervical discs;
- inflammation or rupture of tendons;
- dysfunction of the spinal motion segment;
- internal organ diseases (enlarged thyroid gland, meningitis, pneumonia, subarachnoid hemorrhage, etc.);
- infections (poliomyelitis, tuberculosis);
- neoplasms of the neck (organ, extraorgan and metastases).
Clinical picture
The peculiarity of the clinical picture of this pathology is a combination of signs of cervical osteochondrosis and shoulder arthrosis. At the initial stage of cervicobrachial osteochondrosis, symptoms may be absent. There are only mild discomfort sensations, reminiscent of fatigue after hard physical work. Soon, pronounced pain in the back of the neck and shoulder appears. The pain intensifies after physical exertion, hypothermia, during relapses of chronic or infectious pathologies. The pathology is characterized by the following clinical manifestations:
- stiffness in the shoulder, stiffness;
- crunching, clicking, crackling when raising the arm or moving it back, bending or straightening the joint;
- decreased sensitivity in the neck, shoulder, forearm;
- swelling, swelling of the joint.
Often the skin over the joint becomes pale, moist, and cool to the touch due to circulatory disorders. Initially, clearly localized pain spreads to the forearms, elbows, hands, and upper chest.
Displacement of the vertebrae and discs leads to the appearance of vascular, neurogenic symptoms. The patient complains to the doctor about headaches, dizziness, tinnitus, decreased visual acuity or hearing, and surges in blood pressure.
Which doctor should you consult if pain in the cervical spine radiates to the shoulder?
Any (acute or chronic) manifestation of this symptom may indicate the presence of serious pathological processes in the spine, somatic and oncological diseases and requires urgent and accurate diagnosis. Therefore, any painful manifestations in the neck and shoulder girdle are a serious reason to visit specialists such as:
- neurologist;
- orthopedist-traumatologist;
- rheumatologist;
- vertebrologist
Are you or your loved ones concerned that pain in the cervical spine radiates to the shoulder, interfering with normal movements and disrupting the usual way of life? Specialized medical specialists will determine the exact cause of the ailment and offer you the most effective pain relief regimen!
Other causes of neck-shoulder pain
Neck and shoulder pain can be caused not only by osteochondrosis. They can signal hormonal imbalances, nervousness, the consequences of traumatic exposure and the growth of tumors. It is important not to ignore pain in the cervical-shoulder region, but to seek medical help in a timely manner.
If you are concerned about cervicobrachial radiculitis, make an appointment with a neurologist or vertebrologist. If a cervical-shoulder spasm appears after a fall, bruise, or sudden turn of the head, then you need to see a traumatologist. After excluding cracks and fractures, sprains and ruptures of soft tissues, a consultation with a specialized specialist will be scheduled.
Not uncommon in medical practice is cervicobrachial myositis - inflammation of the scalene muscle under the influence of stress, hypothermia or excessive physical exertion. It manifests itself as sharp pain in the shoulder girdle area. The inflamed, swollen muscle increases in volume and puts strong pressure on the surrounding soft tissue. The secondary process of disruption of the innervation of the upper limb begins.
For myositis, it is important to carry out not only anti-inflammatory treatment, but also subsequent rehabilitation. After such an illness, fibromyalgia lesions often persist. They give a stable pain syndrome at the slightest increase in physical activity.
Incidence (per 100,000 people)
| Men | Women | |||||||||||||
| Age, years | 0-1 | 1-3 | 3-14 | 14-25 | 25-40 | 40-60 | 60 + | 0-1 | 1-3 | 3-14 | 14-25 | 25-40 | 40-60 | 60 + |
| Number of sick people | 0 | 0 | 400 | 1500 | 3500 | 4500 | 7500 | 0 | 0 | 400 | 1500 | 3500 | 4500 | 7500 |
Symptoms
| Occurrence (how often a symptom occurs in a given disease) | |
| Neck pain spreading to arms | 90% |
| Aching pain in the neck | 90% |
| Goosebumps on the arm | 70% |
| Numbness of the entire arm | 70% |
| Weakness in the arm (right or left) | 55% |
| Neck pain, relieved by tilting the head to the healthy side | 50% |
Where can you get treatment for shoulder osteochondrosis?
You can undergo treatment for osteochondrosis in medical centers, hospitals, and clinics in Moscow that treat neurological diseases and diseases of the musculoskeletal system. In severe cases, you may need the help of a surgeon, a hospital and a rehabilitation center. The Yusupov Hospital consists of several clinics in different areas, a diagnostic center, a laboratory, a hospital, and a rehabilitation center. The patient can not only undergo diagnostic tests, but also hospital treatment and rehabilitation.
Mild stage of forearm osteochondrosis: symptoms and treatment
The first signs of the disease may appear at the age of 30-35 years. I am worried about pain in the joint; discomfort appears for no reason when moving the joint. The pain causes a reflex contraction of the muscles of the shoulder girdle and leads to stiffness of the joint. The initial stage of the disease is well treated with medication, massages, and physical therapy. There may also be congenital causes of the development of shoulder osteochondrosis - this is an additional cervical rib, fibrous degeneration of the rib with a displacement from the place of muscle attachment.
Diagnosis of back and shoulder pain
To find the cause of the pain, a computer examination will be required. A doctor from the SmartMed clinic individually selects a set of diagnostic procedures, which may include:
- radiography;
- CT scan;
- Magnetic resonance imaging.
The most accurate and informative method for diagnosing pain in the back and shoulder is MRI. The SmartMed clinic has installed a new Siemens Symphony 1.5 Tesla tomograph, with which you can detect initial pathological changes in the joint and soft tissues, see neoplasms, disorders of innervation or blood circulation. The cost of tomography includes not only the examination itself, but also a consultation with a diagnostician.