Neck and Arm Pains

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What are the causes of neck and arm pains?

There are many causes of neck and arm pains. Some of the causes include usual muscle aches from fatigue, trauma to the area, infection, arthritis, pinched nerve, protruded (herniated) disk in the neck (cervical disk). These, in general, are the more common causes of neck and arm pains. Cancer is a very rare cause.

If a person is having neck and arm pains, how soon should he/she see the doctor?

If the neck and arm pains persist for more than one week, or if they are accompanied by other symptoms, consultation with a physician is recommended.

How are our nerve pinched?

Some of our nerves in the body go through small openings in the bones or between the bones. For example, our spinal cord (which is inside a bony spinal canal or tube, the so-called vertebral canal which protects the cord from injury) sends out branches through small openings (foramina) in the spinal column to supply the neck, arms, body, legs, etc. These openings in the bones could be affected by arthritis (inflammation of the bones and joints) and other bone conditions that lead to the stenosis (narrowing of the foramina), which chokes (pinches) the nerves that run through them. Pinched nerve is mostly commonly associated with arthritis.

What is a herniated disk?

The vertebrae (back bone) are like tiny hallow bricks, one on top of the other, separated by elastic, shock-absorbing disks, forming a hallow center that houses and protects the delicate spinal cord. All these vertebrae form the vertebral canal or spinal canal. The cervical (neck) disks could be damaged by a sudden "wrong" movement of the neck, or by natural aging leading to degeneration. The soft center of the disk (nucleus) is surrounded by a tough outer ring. When damaged, the annulus could be so weak as to be torn or bulge, resulting in herniation (protrusion) of the nucleus, which in turn will press on the nerve. The weak disk annulus could also be so damaged as to flatten (losing its shock-absorbing function) and allow the veterbra above and below the disk to touch (bone rubbing against bone) causing pains.

Why does the arm feel pain and numbness in Cervical Disk?

When the protrusion of the nucleus or bulging of the annulus described earlier occur in the cervical (neck) spine (which is composed of seven vertebrae), it is called Herniated Cervical Disk. The other condition that could cause pinching of the nerve is bone spurs, which are abnormal bone growths that press on the nerve. Any of these situations injure the nerve, which is very sensitive to pressure, causing the nerve to send message impulses to the brain that it is hurting. The brain then sends back through the affected nerve the same message to the muscles, bones, skin, etc. being supplied by that nerve, which will then feel the pain and numbness, and or/weakness. All these message relays take only splits seconds. These relays allow the body to react and respond to the pain and numbness, in order to protect itself.

How severe could this condition be?

Herniated cervical disk could be so severe as to cause excruciating pains, numbess or even weakness of the affected arm, sleepness nights, inability to do simple chores, or total loss of arm function, if neglected. Some patients with this problem can become loners, frustrated or even depressed. If the pinching of the nerve is not treated on time, it might even lead to gangrene (rotting muscles) in the arm, hand and/or fingers on the affected side.

How is Herniated Disk diagnosed?

As always, a detailed medical history and a complete physical examination is essential, including a routine neurological exam. Diagnostic tests include any one or a combination of the following to pinpoint exactly where the level of the spine problem is: X-rays of the spine, MRIs (Magnetic Resonance Imaging), CT Scans , Myelograms, EMGs (Electromyelogram, which tests the function of the nerve in the arm). The physician may also order diskography, to find out which disk is damaged.

Can a Herbolario or a Hilot cure this illness?

Definitely not. The problem is an anatomical one, and one that needs certain part of the vertebra and the disk surgically cut out, and a bone graft applied to patch the hole in the vertebra. Not even a physician can successfully treat this condition with pills, unless the condition is very mild, with minimal symptoms. Once the symptoms are persistent and severe, in spite of conservative medical treatment, then timely surgery is the prudent way to manage this problem before irreversible damage occurs to the arm and hand. Delays in diagnosis and proper and timely treatment due to trial care by a herbolario or hilot might lead to total loss of function of the affected arm. Also, improper manual manipulation of the neck might lead to injury to the cervical spinal cord and cause quadriplegia (total body paralysis).

What is the treatment for the mild or moderate Herniated Cervical Disk?

It is a standard approach to treat this condition conservatively with rest, medications, physical therapy, and exercise to relieve the symptoms. For mild to moderate cervical disk problem, conservative management is usually successful in majority of the cases. However, if the symptoms of neck, arm pains, numbness and especially arm or hand weakness persist, then surgery is the best option to prevent further suffering and severe disability.

How successful is this surgery?

The procedure of choice in modern centers today is "micro-diskectomy," using a small incision in the side or back of the neck. The success rate is very high, much more than 90% of properly diagnosed cases, with almost instant, if not instant, relief of symptoms. While there are possible complications, just like in any surgery, this operation is safe and most rewarding for the patient constantly suffering from intractable pains. The procedure is performed at various centers either by a Neurosurgeon or an Orthopedic Surgeon.

©2003Raoul R. Diez, M.A.O.D.