Arm pain and tingling caused by brachialgia
Arm pain, tingling, or numbness is often assumed to be caused by a problem in the shoulder, elbow, or wrist. However, in many cases, the source of these symptoms is actually the neck. When a nerve in the cervical spine becomes irritated or compressed, pain can travel from the neck into the shoulder, arm, and even the fingers.
This condition is known as brachialgia or cervical radiculopathy, and it can significantly affect everyday activities, from driving and working to sleeping comfortably.
What is Brachialgia?
Brachialgia is the term used to describe pain that radiates from the neck into the arm due to irritation or compression of a spinal nerve. Rather than being a problem with the arm itself, the symptoms originate in the cervical spine.
The nerves that leave the neck supply sensation and muscle function to the shoulders, arms, and hands. If one of these nerves becomes compressed, pain can travel along its entire pathway. Depending on the nerve involved, symptoms may be felt in the shoulder, upper arm, forearm, hand, or specific fingers.
Many patients notice that symptoms worsen when looking up, turning the head, or maintaining the same neck position for prolonged periods.
As symptoms can mimic shoulder injuries, tennis elbow, or carpal tunnel syndrome, it isn’t always obvious that the spine is responsible.
What causes nerve compression?
Several spinal conditions can narrow the space around the nerves as they leave the cervical spine. The most common causes include:
- Cervical disc herniation
- Age-related disc degeneration
- Bone spurs (osteophytes)
- Cervical spinal stenosis
Degenerative changes are responsible for most cases of cervical nerve root compression, with research suggesting they are present in around 70-75% of patients. Cervical disc herniation accounts for approximately 20-25% of cases, often affecting younger or middle-aged adults.
Research also shows that the C6 and C7 nerve roots are affected most frequently, accounting for more than 80% of cases. These nerves supply sensation and movement to much of the arm and hand, explaining why symptoms often extend well beyond the neck itself.
Brachialgia diagnosis and treatment
Diagnosis begins with a detailed clinical assessment. A spinal specialist will ask about symptom patterns, examine strength, sensation, and reflexes, and assess neck movement.
If nerve compression is suspected, imaging such as an MRI scan can identify the affected nerve root and determine the underlying cause. Accurate diagnosis is essential, as treatment depends on whether symptoms are caused by a disc herniation, arthritis, spinal stenosis, or another condition.
Many patients improve without surgery. Initial treatment often includes physiotherapy, activity modification, and medication to reduce pain and inflammation. A cervical epidural steroid injection may be recommended. This delivers anti-inflammatory medication around the irritated nerve, helping reduce swelling and relieve pain.
If nerve compression persists despite conservative treatment, minimally invasive procedures may be considered. One such procedure, Percutaneous Laser Disc Decompression (PLDD), uses laser energy to reduce pressure within a herniated cervical disc, relieving compression on the affected nerve while avoiding the need for traditional open surgery in appropriately selected patients.
Specialist advice for arm pain
Dr Hussien El-Maghraby specialises in diagnosing and treating brachialgia and other cervical spinal conditions. Through careful clinical assessment and advanced imaging, he can identify whether symptoms are arising from the spine and recommend the most appropriate treatment, from conservative care and steroid injections through to minimally invasive procedures such as PLDD.
If you’re experiencing ongoing arm pain, tingling, or numbness, a specialist consultation with Dr El-Maghraby can help identify the underlying causes and can offer an effective pathway to recovery.
