Expert: Scott F. Gillman, DC, DACBSP - 12/7/2006

Question
My husband has had Right arm pain at times, mostly numbness and tingling that radiates towards his Right hand and fingers. He recently was diagnosed with cervicobrachial syndrome, brachial neuritis/radiculitis and neuralgia, neuritis. This makes no sense to us whatsoever.  I've tried different sites on the net to find answers but have had no luck. Maybe you have some literature that will have some information regarding this diagnosis. It will be greatly appreciated.  Thank you for your time. -- Saidy Lopez Medina in Texas

Answer
Dear Saidy,

Even I'm confused with all those big terms!  No wonder you are!  Let's see if I can help you.  Odds are, these are the diagnosis' used by the chiropractor when submitting bills to the insurance company.  Radiculitis literally is the radiating pain that goes into an extremity, such as an arm or hand, as conducted by an irritated nerve.  If your husband has something in his neck that is squooshing and irritating the nerve root, it will likely cause radiculitis, or pain in the arm.   Neuritis literally means inflammation of a nerve. Brachial means upper extremity, such as arm and hand.  The problem with this diagnosis, neuritis, is that likely there is no evidence that a nerve going to the arm or hand is truly inflammed unless your husband had an acute injury with inflammation.  Cervicobrachial syndrome is another general diagnosis that is non-specific.  Cervico(Neck)-Brachial(hand) Syndrome(a collection of a group of signs and/or symptoms that occur together).  In other words, your husband has a collection of symptoms into the hand, with no clear-cut signs, but possibly it has something to do with the neck: thus the non-specific diagnosis of cervicobrachial syndrome.  This is a diagnosis often used when the doctor does not truly know what is causing the symptoms.  Neuralgia (Nerve Pain) again is a fancy way of saying that he has pain caused by a nerve.  From what you are telling me, there is no pain, but instead is numbness and tingling.  The appropriate term for numbness and tingling is "paresthesia," not neuralgia.  It sounds to me like your husband deserves a more thorough work-up, and a list of conditions that need to be ruled out, such as:

Carpal Tunnel Syndrome
Cubital Tunnel Syndrome
Cervical Radiculitis From a Disc irritating a nerve
Cervical Radiculitis From arthritic bone spur compresson on the nerve
Thoracic Outlet Syndrome (from lung tumors, tight muscles, or other things)

Urge the treating doctor to be more specific.  Ask what tests were done to rule out the above diagnostic possibilities.

'Hope this helps.

Dr. G
www.drgillman.com