Brachalgia is nerve pain in the shoulder, arm or hand caused by a problem with the spinal cord or nerve roots in the neck. Just like sciatica, it tends to respond poorly to painkillers and patients can often become tired as it causes issues when finding comfortable position to sleep in. Brachalgia is best investigated and managed early as it can be quite disabling. Many cases respond quickly to image guided spinal procedures, myofascial injections or acupuncture. It may also respond to specific medications that dampens nerve signals.