Definition
Brachialgia - otherwise called cervical radiculopathy - is a painful condition affecting the arm. More precisely, the pain that is perceived is neuropathic pain.
Brachialgia can affect indifferently both young patients and elderly patients.
Causes
Brachialgia is caused by irritation or crushing of a spinal nerve in the neck and is one of the symptoms that can occur in different types of diseases. These include: cervical disc hernia (which is the most common cause of brachialgia in young people), cervical arthrosis, degenerative diseases of cervical discs, tumors of the spine, intervertebral prolapse, osteophytes and narrowing of the foraminal and spinal canal (this is the most common cause of brachialgia in the elderly).
Symptoms
As mentioned, brachialgia consists in the perception of a sensation of pain in the arm. This sensation can also radiate to the cervical and scapular area. Furthermore, it is not uncommon for the painful manifestation to be associated with muscle weakness and paraesthesia.
In some cases, the patient with brachialgia may also lose the sensitivity of the skin on the arm at the compromised nerve.
Information on Brachialgia - Drugs for the Treatment of Arm Pain is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Brachialgia - Medications for the Treatment of Arm Pain.
drugs
Since brachialgia is the symptom of a pathology, the treatment will depend on the primary cause underlying the painful manifestation and will be aimed at its cure.
However, the doctor may prescribe a symptomatic NSAID-based pharmacological therapy and - if the pain is particularly severe - based on opioid analgesics, or based on anticonvulsants.
In the most severe cases where neuropathic pain is so strong as to compromise the patient's normal daily activities, the doctor may decide to administer anesthetic drugs, injecting them directly into the compromised nerve. Unfortunately, however, this therapy is effective only for a few days, after which, brachialgia manifests itself again and with the same intensity.
In addition to pharmacological treatment, it can also be useful to undergo physiotherapy, massage, acupuncture or osteopathy.
If, on the other hand, the aforementioned conservative therapies are not sufficient to control brachialgia, then the doctor may decide to resort to surgery.
NSAIDs
Non-steroidal anti-inflammatory drugs are the first-line symptomatic treatment of brachialgia, thanks to their marked anti-inflammatory and analgesic properties.
There are several active ingredients that can be used for this purpose. Among these, we recall:
- Ibuprofen (Brufen ®, Moment ®, Nurofen ®, Arfen ®, Actigrip fever and pain ®, Vicks fever and pain ®): ibuprofen is available in different pharmaceutical formulations suitable for different routes of administration.
The dose of drug to be administered orally should not exceed 1, 200-1, 800 mg of active ingredient per day. The exact amount of medicine to be taken will be established by the doctor on an individual basis, depending on the severity of the pain afflicting the patient.
- Naproxen (Momendol ®, Synflex ®, Xenar ®): also naproxen is available in different pharmaceutical formulations. When used orally, the usual dose of naproxen is 500-1, 000 mg per day, to be taken in divided doses every 12 hours. However, even in this case, the doctor will determine the exact amount of active ingredient that each patient will have to take.
- Ketoprofen (Artrosilene ®, Orudis ®, Oki ®): the dose of ketoprofen usually administered orally is 150-200 mg per day, to be taken in 2-3 divided doses after meals.
Opioid analgesics
If brachialgia is particularly intense, the doctor may decide to use opioid analgesics.
However, these drugs must be used very carefully, under the strict supervision of the doctor and in situations of real need. This is because opioid analgesics can cause considerable side effects, including tolerance and dependence.
Among the different active ingredients that can be used, we remember the:
- Tramadol (Contramal ®, Patrol ®): tramadol is a powerful analgesic available in different pharmaceutical formulations that allow it to be administered orally, rectally and parenterally.
Generally, therapy with tramadol begins with the administration of 50-100 mg of active ingredient. Subsequently, if deemed necessary, the doctor may decide to increase the amount of drug to be taken, until the optimal dosage is reached for each patient, so as to obtain adequate pain control.
Anticonvulsants
The anticonvulsants are drugs that are normally used in the treatment of convulsive disorders, including epilepsy.
However, some active ingredients belonging to this class of drugs may be useful for treating neuropathic pain. Therefore, they can also be useful in the treatment of brachialgia.
Among these active ingredients, we recall:
- Gabapentin (Neurontin ®): for the treatment of neuropathic pain, the initial dose of gababentin usually used in adult patients ranges from 300 mg to 900 mg a day, to be taken orally. Later, the doctor may decide to increase the amount of drug administered, to reach the most adequate maintenance dose for each patient.
- Carbamazepine (Tegretol ®): Carbamazepine is also available for oral administration. The initial dose of medication usually used in adults is 200-400 mg a day. The doctor may decide to increase the amount of drug administered until the pain disappears completely, and then reduce it again so as to give the patient the least effective dose to maintain control of symptoms.
In elderly patients, the doses of carbamazepine administered will be lower than those usually used in adult patients.
