Jose S. Santiago M.D.

Brachial Neuralgia Brachial neuralgia- radiating pain in the shoulder and upper arm - Caused by damage to a nerve in the neck

Brachial Neuralgia Brachial plexus: from C5 to T1

Brachial Neuralgia Patterns of nerve root pain in the arm

Brachial Neuralgia Treatment: 1. Anti-inflammatory drugs 2. Analgesics 3. Physiotherapy 4. Surgery

Brachial Neuralgia A 40 year-old man came to the Physical Therapy Department with neck pain. His neck pain started about 2 weeks prior to consultation. He said the pain was sometimes moving from his neck to his right shoulder and down to his right arm.

P: Patient T: Therapist P: _____. Can you help me? T: Yes. What can I do for you? P: I have an ______ for ________. T: Can I have your _____? P: Yes, here it is. T: Come in. Please ______. What’s your problem?

P: Patient T: Therapist P: I have ______ for the past ______. I saw the _______. He gave me some ______, but the pain was not reduced. So, he ______ to take physical therapy. T: Okay, I ____ your chart. The doctor has prescribed ______ and _______.

P: Patient T: Therapist P: How long should I _____ the treatment? T: For one week. Now, I will explain the treatment to you. Please ______ your shoes and _______ in the bed. First, we will ____ with hot pack. In this treatment you will feel some ____.If you feel ____ please call me.

P: Patient T: Therapist P: Okay. I will call you. Sometime later: P: Sir, can you please ____ here? T: Yes. What ______? P: I feel too hot. Please take it off. T: I will ____ one more towel so that it is not so hot.

P: Patient T: Therapist P: Yes, do that please. T: How do you ______? P: I ____ good now. T: If you have any other _____ please _____ me again. P: Sure.

P: Patient T: Therapist T: The treatment is _____. I will _____ the next treatment. Can you ____ me the pain area? P: Yes. It is near the _____ and radiates down to the ______. T: I will ____ the gel on the ___. It will be a little ___. Is there any _______? P: No. I am comfortable.

P: Patient T: Therapist A few minutes later: T: Please _______. The treatment is __. I will teach you some ______. Please follow those ______ at home. P: Yes. I will do that. T: Sit straight and try to do ____ in and ____ out. Like this.

P: Patient T: Therapist P: Like this? T: Yes. Then place a ______ in the neck region when you take a rest in the ____ position. P: Sure. _____ at what time can I come here? T: In the _____ at ____ 0’clock. P: Okay. I will come here at that time. Thanks.