Category Archives: Cervicobrachial Syndrome
Cervicobrachial syndrome is a nonspecific term describing some combination of pain, numbness, weakness, and swelling in the region of the neck and shoulder. The term may have originated with Kenneth Aynesworth, who used it to describe cases he felt were thoracic outlet syndrome. These cases included the rare conditions of objectively verifiable vascular compression or neurologic compression due to thoracic outlet syndrome, and the common condition of objectively unexplainable similar symptoms. This diagnosis of objectively unexplainable symptoms was used as a synonym for the symptoms of many workers in the Australian epidemic of “repetitive strain injury” and was a common diagnosis in the earlier Japanese epidemic of neck and shoulder symptoms in workers. There is still an ICD-9 code for this diagnosis (723.3), although now more physicians use the codes for shoulder pain and/or neck pain.
The word “syndrome” means a collection of symptoms commonly seen together but for which there is no known explanation. When medical science discovers the cause of a disease or condition, it is renamed. For example, “Down’s syndrome” has been renamed “Trisomy 21” to denote the extra chromosome that causes this condition.
The term “cervicobrachial syndrome” should therefore denote a collection of neck and arm symptoms for which there is no known cause. If a particular patient can be proven to have cervical radiculopathy or vascular compression in the thoracic outlet, then the specific and objectively documented diagnosis should be used.
The term “cervicobrachial syndrome” is used by some physicians to describe symptoms they suspect come from cervical nerve root irritation that cannot be documented, whereas other physicians reserve the term for patients whose symptoms may come from undocumentable thoracic outlet syndrome. Still other physicians use the term as a synonym for “myofascial pain syndrome” with symptoms in the neck and/or shoulder that are believed to arise in muscle.
The definition of “cervicobrachial syndrome” is probably unique to the doctor who uses the term. It may be that an alternate, objectively documentable diagnosis is present, but most often the diagnosis of “cervicobrachial syndrome” refers to symptoms for which there is no proven diagnosis.
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