Cervicobrachial pain - How Often is it Neurogenic?

Gangavelli, Ranganath; Ns, Nair; Bhat, AK; Solomon, John M.

doi:10.7860/jcdr/2016/16456.7492

Cited by 12 publications

(17 citation statements)

References 24 publications

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“…Finally, the musculoskeletal or neuropathic origin of CP suffered by the subjects was not established and may clearly influence the results 52 . According to Gangavelli et al, only 19.9% of CP cases may be consequence of neurogenic origin 3 . In addition, pain catastrophizing or beliefs may alter the follow-up, outcome measurements and treatments effectiveness 53 , 54 .…”

Section: Discussionmentioning

confidence: 99%

“…Most CP studies refer an incidence of 83 per every 100.000 individuals based on Radhakrishnan et al 2 findings, accompanied by a 5 year prevalence of symptoms. 2016 up to date data reported by Gangavelli et al 3 concludes that only 19.9% of CP cases are truly of neurogenic origin.…”

Section: Introductionmentioning

confidence: 96%

“…Cervicobrachial pain (CP) is defined as the presence of neck pain that radiates or referrers to the upper limb that may be derived from neuropathic, pathomechanical, and degenerative disorders, as well as infections and systemic diseases 1 - 3 . Early descriptions involving CP can be found in the Edwin Smith medical papyrus dated 3700 BC 4 , never the less, recent information regarding the incidence of this condition is not available.…”

Section: Introductionmentioning

confidence: 99%

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Is pharmacologic treatment better than neural mobilization for cervicobrachial pain? A randomized clinical trial

Calvo‐Lobo¹,

Unda-Solano²,

López‐López³

et al. 2018

Int. J. Med. Sci.

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Purpose: This study aim was to compare the effectiveness of the median nerve neural mobilization (MNNM) and cervical lateral glide (CLG) intervention versus oral ibuprofen (OI) in subjects who suffer cervicobrachial pain (CP).Methods: This investigation was a, multicenter, blinded, randomized controlled clinical trial (NCT02595294; NCT02593721). A number of 105 individuals diagnosed with CP were enrolled in the study and treated in 2 different medical facilities from July to November 2015. Participants were recruited and randomly assigned into 3 groups of 35 subjects. Intervention groups received MNNM or CLG neurodynamic treatments, and the (active treatment) control group received an OI treatment for 6 weeks. Primary outcome was pain intensity reported through the Numeric Rating Scale for Pain (NRSP). Secondary outcomes were physical function involving the affected upper limb using the Quick DASH scale, and ipsilateral cervical rotation (ICR) using a cervical range of motion (CROM) device. Assessments were performed before and 1 hour after treatment for NRSP (baseline, 3 and 6 weeks) and CROM (baseline and 6 weeks), as well as only 1 assessment for Quick DASH (baseline and 6 weeks).Results: Repeated-measures ANOVA intergroup statistically significant differences were shown for CP intensity (F(2,72) = 22.343; P < .001; Eta2 = 0.383) and Quick DASH (F(2,72) = 15.338; P < .001; Eta2 = 0.299), although not for CROM (F(2,72) = 1.434; P = .245; Eta2 = 0.038). Indeed, Bonferroni´s correction showed statistically significant differences for CP intensity (P < .01; 95% CI = 0.22 - 3.26) and Quick DASH reduction (P < .01; 95% CI = 8.48 - 24.67) in favor of the OI treatment at all measurement moments after baseline.Conclusions: OI pharmacologic treatment may reduce pain intensity and disability with respect to neural mobilization (MNNM and CLG) in patients with CP during six weeks. Nevertheless, the non-existence of between-groups ROM differences and possible OI adverse effects should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is pharmacologic treatment better than neural mobilization for cervicobrachial pain? A randomized clinical trial

Calvo‐Lobo¹,

Unda-Solano²,

López‐López³

et al. 2018

Int. J. Med. Sci.

View full text Add to dashboard Cite

show abstract

“…The mechanosensitive neural tissue is considered a primary feature in cervicobrachial pain syndrome with pain in the upper quarter region (UQR) [ 10 , 11 ]. Nevertheless, Gangavelli et al reported that only 19.9% of cases are of neurogenic origin [ 12 ]. In addition, Butler had proposed that not all “positive tension tests” indicate adverse neurodynamics, and the neurodynamics tests are not specific enough to indicate abnormal neural mobility [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of deep cervical fascial manipulation and yoga postures on pain, function, and oculomotor control in patients with mechanical neck pain: study protocol of a pragmatic, parallel-group, randomized, controlled trial

Bhat

Fernández‐de‐las‐Peñas

et al. 2021

Trials

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Introduction Mechanical neck pain (MNP) is a commonly occurring musculoskeletal condition that is usually managed using electrical modalities, joint mobilization techniques, and therapeutic exercises, but has limited evidence of their efficacy. Pathology (densification) of the deep cervical fascia that occurs due to the increased viscosity of hyaluronic acid (HA) may induce neck pain and associated painful symptoms of the upper quarter region. Fascial manipulation (FM) and yoga poses are considered to reduce the thixotropy of the ground substances of the deep fascia and improve muscle function. The purpose of this study is to investigate the effect of FM and sequential yoga poses (SYP) when compared to the usual care on pain, function, and oculomotor control in MNP. Methods This FaCe-Man trial will recruit 160 patients with subacute and chronic mechanical neck pain diagnosed using predefined criteria. Participants will be randomized to either the intervention group or the usual care group, using a random allocation ratio of 1:1. Patients in the intervention group will receive FM (4 sessions in 4 weeks) and SYP (12 weeks) whereas the standard care group will receive cervical mobilization/ thoracic manipulation (4 sessions in 4 weeks) and therapeutic exercises (12 weeks). The primary outcome is the change in the numeric pain rating scale (NPRS). The secondary outcomes include changes in the patient-specific functional scale and oculomotor control, myofascial stiffness, fear-avoidance behavior questionnaire, and elbow extension range of motion during neurodynamics test 1. Discussion If found effective, FM along with SYP investigated in this trial can be considered as a treatment strategy in the management of mechanical neck pain. Considering the magnitude of the problem, and the pragmatic and patient-centered approach to be followed, it is worth investigating this trial. Trial registration ClinicalTrials.gov CTRI/2020/01/022934. Registered on January 24, 2020 with ctri.nic.in. Clinical Trials Registry – India.

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“…But Gangavelli et al. have reported that only 20% of CBP cases are of neurogenic origin [ 3 ]. Butler has highlighted that a positive Upper limb neural tension (ULNT) test does not necessarily indicate the adverse mechanical disorder of the nervous system [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The plausible role of Deep Cervical Fascia and its continuum in chronic craniofacial and Cervicobrachial Pain: A case report

Fernandes

Cruz

et al. 2020

Heliyon

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Background The painful conditions of the Upper quarter region (UQR) such as chronic Craniofacial Pain (CFP) and Cervicobrachial Pain (CBP) usually occur with a plethora of symptoms. Although biological and psychosocial factors are attributed to such conditions, the involvement of the Deep Cervical Fascia (DCF) is ambiguous and needs further exploration. Objective We reported a case of CFP and CBP with an intent to showcase the possible involvement of impaired DCF in such presentations and to explore the short-term effect of Fascia directed approach (Fascial Manipulation). Methods This is a report of a 25-year-old female college student with chronic head, temporomandibular, neck, and arm pain over the past four years with acute pain exacerbation. After identifying the densified Centre of Coordination points along the myofascial continuum of the DCF, Fascial Manipulation (FM) was performed by deep manual friction. The patient-reported outcomes such as the Numerical Pain Rating Scale (NPRS), Temporomandibular disability index (TMDI), and Patient-Specific Functional Scale (PSFS) were assessed. Results Following FM treatment, there is a reduction in pain and improved function between the baseline and follow up evaluation after one week based on all the outcomes (NPRS, PSFS, and TMDI). Conclusion This case report highlights the possible role of dysfunction of the DCF and the importance of assessing myofascial chains in patients with pain in the UQR. The report has also shown that FM may be beneficial and can be considered an adjunct in the rehabilitation of chronic CFP and CBP. Nevertheless, future studies with multiple sessions and follow-ups are imperative.

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Cervicobrachial pain - How Often is it Neurogenic?

Cited by 12 publications

References 24 publications

Is pharmacologic treatment better than neural mobilization for cervicobrachial pain? A randomized clinical trial

Is pharmacologic treatment better than neural mobilization for cervicobrachial pain? A randomized clinical trial

Effectiveness of deep cervical fascial manipulation and yoga postures on pain, function, and oculomotor control in patients with mechanical neck pain: study protocol of a pragmatic, parallel-group, randomized, controlled trial

The plausible role of Deep Cervical Fascia and its continuum in chronic craniofacial and Cervicobrachial Pain: A case report

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