Physiotherapeutic Intervention for Cervicobrachial Pain Syndrome: A Scoping Review

Introduction: Cervicobrachial Pain Syndrome (CBPS) is a disorder of enhanced mechanosensitivity to the neural structure, also known as lower cervical pain Syndrome. Cervicobrachial pain is managed by manual and traditional therapy, besides medical management. Aim: The aim of this scoping analysis was to determine the efficacy of the protocols for cervicobrachial syndrome treatment. Materials and Methods: Until March 2020, initial literature searches were performed through robust online electronic databases such as “Scopus” “MEDLINE via PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Sciences and Cochrane Controlled Trials Register in Cochrane Library, Physiotherapy Evidence Database (PEDro), ProQuest 5000 International, ProQuest Health and Medical Complete, and following keywords were used “Neck Disability Index, “Upper Limb Tension test, “Goniometry “Neck pain,” “Cervicobrachial Pain Syndrome,” Thirty six studies were included in this scoping study using PRISMA guidelines. Results: There is little evidence of manual and conventional physiotherapy treatment of cervicobrachial pain and its efficacy. Key advantages have been reported in manual therapy and exercises methods for pain relief and rehabilitation. Electrotherapeutic modalities, neck strengthening exercises, traction and methods for handling soft tissue are considered to be less effective in managing cervicobrachial pain syndrome relative to manual therapy. Lateral cervical glide and median nerve slider technique (neurodynamic) have useful effects as a treatment intervention in multiple cases of cervicobrachial pain syndrome, such as the median nerve slider technique and contra-lateral cervical glide technique. Recommendations for the management of cervicobrachial syndrome in practice should be encouraged in additional trials of innovative treatment methods. Conclusion: Studies should identify which cervicobrachial pain respond to specific interventions for immediate and effective response so as to increase the quality of life of the patients. Further research with innovative techniques of therapeutic approach would facilitate practice guidelines for the management of cervicobrachial syndrome.

Peculiarities of changes in the sagittal balance of the cervical spine in cervicobrachial syndrome

Objective. To analyze clinical manifestations of cervicobrachial syndrome and identify their relationship with sagittal imbalance using data of MRI and radiological examination.Material and Methods. Clinical manifestations of cervicobrachial syndrome associated with degenerative changes in the spine were studied in 22 patients. Clinical examination, radiography of the cervical spine, electroneuromyography of the upper extremities, and MRI study were performed. The intensity of the pain syndrome was assessed by VAS, and the quality of life – by the NDI questionnaire. The sagittal balance of the cervical spine was evaluated according to the following characteristics: angle of T1 slope, atlantoaxial (C1–C2) angle, degree of shift of the center of gravity of C2–C7, and Cobb angle.Results. The pain intensity in cervicobrachial syndrome correlates with sagittal balance changes in the C2–C7 Cobb angle (r = 0.656; p < 0.05), the angle of T1 vertebra slope (r = 0.520; p < 0.05), and in the degree of shift of the center of gravity of C2–C7 (r = 0.756; p < 0.02). Differences between MRI and radiological results of the sagittal balance measurement are not significant (p < 0.04).Conclusion. The study of the sagittal balance can be included in the algorithm for diagnosing osteochondrosis of the cervical spine. The MRI, along with spondylography, can be used to assess the state of sagittal balance. Understanding the identified relationships can help in determining the program of etiopathogenetic treatment of patients with cervicobrachial syndrome with obligatory including the sagittal balance correction in the program.

CERVICOBRACHIAL SYNDROME IN PATIENTS WITH SPINAL OSTEOCHONDROSIS

The article presents clinical profile of patients with cervical osteochondrosis and cervicobrachial syndrome, results of cliniconeurological examination including X-ray diagnostics (plain frontal and lateral radiography of cervical spine, functional tests, frontal and lateral X-ray imaging of large joints of upper limbs), MRI of cervical spine, stimulation electroneuromyography and osteodensimetry. Statistical processing with definition of nonparametric test and correlation coefficient was performed using SPSS 22.0.0 software. Pearson and Spearman nonparametric tests were used for correlation analysis. Examination of patients with cervicobrachial syndrome revealed that bone tissue condition of a limb with pain syndrome slightly differs from the bone tissue condition of a healthy limb and is within normal range. Neuromyography showed that abnormality of a functional condition of studied nerves of upper limbs was not pronounced and was registered on both limbs. As a result of our research we can suppose that asymmetric abnormal focus inhibits peripheral and central chains of locomotor system both on injured and healthy limbs. Differences in functional condition of peripheral nerves of upper limbs in patients with cervicobrachial syndrome and healthy people are statistically significant and allow us to consider them as a sign of decompensation which prevent healthy performance.

Evaluation of the Effectiveness of Osteopathic Treatment of the Right Sided Cervicobrachial Syndrome with the Help of Electropunctural Diagnostics

Changes in adaptation and psychosomatic alterations in the body reflect on the state of the acupunctural channels in patients presenting cervicobrachial syndrome. This fact permits to choose the best algorithm of osteopathic treatment.