Overview
Brachial (cervical) neuritis involves inflammation or irritation of nerves in the brachial plexus, often leading to pain, numbness, and weakness in the arm and shoulder. 1Diagnosis
Cervical Rotation Lateral Flexion (CRLF) Test: Recommended for assessing first rib movement restriction in patients with brachialgia 1.
Expiration-Inspiration (E-I) Test: Palpation beneath the clavicles during breathing to detect hypomobility of the first rib, validated by cineradiography 2.
Cineradiography: Objective assessment of first rib mobility, particularly useful in confirming findings from palpatory tests 2.Management
Physical Therapy: Scalenus muscle activation techniques may restore first rib mobility, as seen in restoring movement on the affected side 2.
Manual Therapy: Techniques aimed at improving rib mobility and reducing nerve compression 1.
No Specific Drug Doses Mentioned: Evidence does not specify particular drug classes or doses for treatment 12.Special Populations
No Specific Guidance Provided: Abstracts do not cover management in pregnancy, pediatrics, elderly, or patients with comorbidities 12.Key Recommendations
Include the Cervical Rotation Lateral Flexion test in the clinical evaluation of patients with brachialgia to assess first rib mobility restriction (Evidence: Strong 1).
Utilize the Expiration-Inspiration test complemented by cineradiography for objective assessment of first rib hypomobility in patients with chronic brachialgia (Evidence: Moderate 2).
Consider manual therapy techniques targeting scalenus muscle activation to improve rib mobility and alleviate symptoms (Evidence: Expert opinion 2).References
1 Lindgren KA, Leino E, Manninen H. Cervical rotation lateral flexion test in brachialgia. Archives of physical medicine and rehabilitation 1992. link
2 Lindgren KA, Leino E, Manninen H. Cineradiography of the hypomobile first rib. Archives of physical medicine and rehabilitation 1989. link