“…[2][3][4] The intensity of pain in cervicobrachial syndrome can reach severe or very severe levels, with symptomatic relief being the primary goal of physical therapies (cervical collar, kinesiotherapy, local heat application, vertebral manipulation) and pharmacologic treatment (nonsteroidal anti-inflammatory drugs, tramadol, systemic corticosteroids, anxiolytics, muscle relaxants, and opioids). Equivocal efficacy has been found with transcutaneous electrical stimulation, 5 infiltration of trigger points with local anesthesia 6 and acupuncture. 7 Variable efficacy has been demonstrated with physical treatments, and although pharmacologic treatment would appear to be a rational choice, it is not considered first-line, especially for chronic pain, because of the possible long-term side effects of some of the drugs.…”