Definition
Brachialgia - otherwise referred to as cervical radiculopathy - is a painful condition that affects the arm. More precisely, the pain that is perceived is a neuropathic pain.
Brachialgia can affect both young and elderly patients alike.
Causes
Brachialgia is caused by an irritation or crushing of a spinal nerve in the neck and is one of the symptoms that can occur in different types of pathologies. common of brachialgia in young people), cervical osteoarthritis, degenerative diseases of the 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 of 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 muscle weakness and paraesthesia to be associated with the painful manifestation.
In some cases, the brachialgia patient may also lose the sensation of the skin of the arm at the compromised nerve.
The information on Brachialgia - Medicines 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 - Arm Pain Medicines.
Medicines
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.
In any case, the doctor can prescribe a symptomatic drug therapy based on NSAIDs and - if the pain is particularly severe - based on opioid analgesics, or based on anticonvulsants.
In the most severe cases in which the 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 the brachialgia manifests itself again and with the same intensity.
Furthermore, in conjunction with drug treatment, it may be useful to undergo physiotherapy, massage, acupuncture or osteopathy.
If, however, the aforementioned conservative therapies are not sufficient to control brachialgia, then the doctor may decide to resort to surgery.
The following are the classes of drugs most used in the therapy against brachialgia and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and dosage most suitable for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment.
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 remember:
- Ibuprofen (Brufen ®, Moment ®, Nurofen ®, Arfen ®, Actigrip fever and pain ®, Vicks fever and pain ®): Ibuprofen is available in various 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 determined by the doctor on an individual basis, depending on the severity of the pain afflicting the patient. - Naproxen (Momendol ®, Synflex ®, Xenar ®): naproxen is also available in different pharmaceutical formulations. When used orally, the dose of naproxen usually given is 500-1,000 mg per day, to be taken in divided doses every 12 hours. In any case, 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
In the event that the brachialgia is particularly intense, the doctor may decide to resort to the use of opioid analgesics.
However, these drugs must be used with great caution, under the strict supervision of the doctor and in situations of real need. This is because opioid analgesics can cause not indifferent side effects, among which we find tolerance and dependence.
Among the various active ingredients that can be used, we mention the:
- Tramadol (Contramal ®, Patrol ®): Tramadol is a powerful analgesic available in various pharmaceutical formulations that allow for oral, rectal and parenteral administration.
Generally, tramadol therapy begins with the administration of 50-100 mg of the active ingredient. Subsequently, if deemed necessary, the doctor may decide to increase the amount of drug to be taken, until the optimal dosage for each patient is reached, in order to obtain adequate pain control.
Anticonvulsants
Anticonvulsants are drugs that are normally used in the treatment of seizure 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 remember:
- 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 per day, to be taken orally. Thereafter, the doctor may decide to increase the amount of drug administered until the most appropriate maintenance dose for each patient is reached.
- Carbamazepine (Tegretol ®): Carbamazepine is also available for oral administration. The starting dose of the drug usually used in adults is 200-400 mg per day. The doctor may decide to increase the amount of drug administered until the pain disappears completely, and then reduce it again in order to give the patient the lowest 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.
