Brachial Plexus Neuralgia

　　Brachial plexus neuralgia can be divided into primary and secondary types, with the latter being more common. The cause of primary brachial plexus neuralgia is unknown and may be a hypersensitivity disease, with occasional familial cases occurring in mild trauma, injection, vaccination, and mild systemic infection. Secondary brachial plexus neuralgia is caused by compression of adjacent lesions of the brachial plexus, that is, compression of the nerve roots (cervical spondylosis, disc herniation, tuberculosis, tumor, fracture, dislocation, spinal cord tumor, and arachnoiditis, etc.) and compression of the nerve trunk (thoracic outlet syndrome, cervical rib or neck tumor, axillary lymphadenopathy (metastatic cancer), clavicle fracture, pulmonary sulcus tumor. According to the site of injury, it can be further divided into radicular brachial plexus neuralgia and trunk brachial plexus neuralgia. The causes of radicular brachial plexus neuralgia include various injuries of the cervical spine, spinal cord tumor, extradural metastatic cancer, etc. The causes of trunk brachial plexus neuralgia include cervical-thoracic outlet syndrome, brachial plexus neuritis, neck tumor, trauma, tuberculosis, pulmonary apex tumor, etc.

　　Secondary brachial plexus neuralgia can be associated with the onset of cervical spondylosis.

　　Cervical spondylosis is a syndrome of a series of clinical symptoms caused by degenerative changes in the cervical intervertebral discs and osteophytes in the cervical vertebrae, and is a type of vertebral disease. The clinical manifestations are often pain in the neck, shoulders, arms, scapula, upper back, and chest area, numbness in the arms and hands, muscle atrophy, and even paralysis of the limbs. Cervical spondylosis can occur at any age, with middle-aged and elderly people over 40 years old being more common. However, with the change of lifestyle and the insufficient active prevention and health care, this disease is not uncommon in adolescents as well.

　　Pain is localized to the range of the brachial plexus, stimulation or compression of the brachial plexus can exacerbate the pain.

　　1. Idiopathic brachial plexus neuralgia or brachial plexitis:It refers to the syndrome of pain, muscle weakness, and muscle atrophy in the scapular girdle and upper limb (neuralgic amyotrophy), symptoms recur, autosomal dominant inheritance (17q25 site), more common in adults, with history of infection and vaccination, acute or subacute onset, accompanied by fever and systemic symptoms at the beginning, typically with severe pain in the shoulder and upper limb, upper limb muscle weakness, reflex changes, sensory disturbance. The C5 and C6 segments are prone to be involved, leading to muscle atrophy, unilateral, which can also be bilateral.

　　2. Secondary brachial plexus neuralgia:Pain in the shoulder and upper limb to varying degrees, persistent or paroxysmal exacerbation, pain in limbs and at night is obvious, sensory disturbance in the distribution area of the brachial plexus, muscle atrophy, decreased tendon reflex, autonomic nerve disorder. If the disease is caused by cervical spondylosis, it often starts between 40 to 50 years old, more common in males; the course is slow, recurrent; compression of the sensory nerve root (C5, C6 is more common) leads to radicular neuralgia, which is mostly tingling pain in the radial side of the forearm and fingers, accompanied by sensory减退; compression of the motor nerve root causes muscle pain, often in the upper limb proximal, shoulder, scapular area, persistent dull pain and deep pricking discomfort, limited movement of the shoulder, long course can lead to frozen shoulder.

　　Brachial plexus neuralgia can be divided into primary and secondary types, with the latter being more common. According to the site of injury, it can be further divided into radicular brachial plexus neuralgia and trunk brachial plexus neuralgia. The causes of radicular brachial plexus neuralgia include various injuries of the cervical spine, spinal cord tumors, epidural metastatic cancer, etc. The causes of trunk brachial plexus neuralgia include cervical-thoracic outlet syndrome, brachial plexitis, cervical tumors, trauma, tuberculosis, pulmonary apex tumors, etc.

　　According to the clinical manifestations, selective shoulder joint, cervical X-ray film, cerebrospinal fluid examination, electromyogram, upper limb blood flow, nerve conduction velocity, cervical CT or MRI examination should be performed.

　　Therapeutic Diet for Chronic Pain:

　　1. Corydalis Yanhusuo Porridge:10 grams of Corydalis Yanhusuo, 10 grams of Carica papaya, 150 grams of rice. Boil Corydalis Yanhusuo and Carica papaya, then remove the residue and take the juice. Add an appropriate amount of water and cook with rice to make porridge. Take twice a day, in the morning and evening.

　　2. Rhizoma Cyperi and Salvia Miltiorrhiza Porridge:15 grams of Rhizoma Cyperi, 10 grams of Salvia Miltiorrhiza, 150 grams of millet. Boil Rhizoma Cyperi and Salvia Miltiorrhiza, then remove the residue and take the juice. Add an appropriate amount of water and cook with millet to make porridge. Take twice a day, in the morning and evening.

　　3. Herba Angelicae Pubescentis and Black Soybean Soup:15 grams of Herba Angelicae Pubescentis, 5 grams of Herba Asari, 80 grams of black soybeans. Boil Herba Angelicae Pubescentis and Herba Asari, then remove the residue and take the juice. Add the pre-soaked black soybeans and an appropriate amount of water (about 2000 milliliters) and simmer over low heat to 500 milliliters. Take twice a day, 50 to 100 milliliters each time.

　　4. Angelica Sinensis and Cimicifuga Decoction:Angelica Sinensis 15 grams, Astragalus 20 grams, Aconitum carmichaelii 10 grams, Chuanxiong 10 grams,赤芍5 grams,小米50 grams, 大米100 grams. Boil Angelica Sinensis, Astragalus, Aconitum carmichaelii, Chuanxiong, and赤芍 and then remove the dregs, mix with小米and 大米 and add an appropriate amount of water to cook into porridge, taken twice a day in the morning and evening. Dietary requirements: The diet should be rich in nutrition, with high calories, high protein, and easily digestible foods, avoid spicy and刺激性, cold and raw, and greasy and rich foods, in order to enhance the body's ability to resist diseases.

　　One, Prevention:The limbs should be allowed to rest appropriately, reduce the activity of the affected limb, flex the forearm and hang it in front of the chest. If the cervical spondylosis causes it, pay attention to not fix the head position for too long, do not use too thick pillows, and avoid excessive flexion of the neck.

　　Two, Traditional Chinese Medicine Treatment Methods for Brachial Plexus Neuralgia

　　Traditional Chinese Medicine Treatment:

　　1. Shujinluo Diding (Curcuma,五味藤, Rhizoma Polygoni Cuspidati, Radix et Rhizoma Scutellariae, Mentha Haplocalycis)

　　Effects: Activate blood circulation and resolve blood stasis, relax the tendons and collaterals, expel wind and dampness, reduce swelling and relieve pain.

　　Indications: Wind-cold-damp BiSyndrome.

　　Usage: Spray on the affected area 6-8 times a day, with 2 days of continuous use as one course of treatment, with an overall effective rate of 94.4%.

　　2. Bao Bao Dan Linji

　　Effects: Disperse blood stasis and relieve pain.

　　Indications: BiSyndrome due to cold-damp obstruction and blood stasis obstruction, with an overall effective rate of 94.23%.

　　3. Shen Gui Zao Zao Wan

　　Composition: Ginseng, Cinnamon, Astragalus, Atractylodes, Angelica Sinensis, Chuanxiong, Safflower, Frankincense, Myrrha, Earthworm, Silkworm, Green Snake, Mulberry, Pueraria Lobata, Stephania, Saposhnikovia Divaricata.

　　Effects: Tonify Qi and resolve blood stasis, warm the meridians and collaterals, relax the tendons and collaterals, expel wind and relieve pain.

　　Indications: Brachial Plexus Neuralgia.

　　Usage: Take one pill after breakfast and dinner every day, with a course of 45 days. Treatment of 180 cases, 24 cases basically controlled, 72 cases significantly effective, 66 cases effective, with an overall effective rate of 90%.

　　4. Tianzong Point Compound Injection

　　Composition: Angelica Sinensis Injection 2ml, Vitamin B12 1ml, Vitamin B12 1ml, 2% Lidocaine 5ml, Dexamethasone 2ml, 0.9% Sodium Chloride 10ml.

　　Indications: Cervical Spondylosis of the Radiculopathic Type.

　　Usage: Injection at both Tianzong points, combined with Jiebi Decoction in some cases, with an overall effective rate of 97.7%.