Brachial Plexus Injuries
What is a Brachial Plexus Injury?
The branchial plexus is a network of five nerves that sends signals from the spinal cord to the shoulder, arm, and hand. A brachial plexus injury occurs when the nerves are stretched, compressed, or ripped apart or torn away from the spinal cord. More specifically, the types of brachial plexus injuries include:
- Brachial plexus neuropraxia (stretch) – where the nerves are stretched to the point that injury occurs
- Brachial plexus rupture – where the nerve tears either partially or completely
- Brachial plexus neuroma – where scar tissue forms on the nerve
- Brachial neuritis – a rare progressive disorder of the nerves, also called Parsonage Turner syndrome
- Brachial plexus avulsion – where the root of the nerve is completely separated from the spinal cord
What are the Symptoms of a Brachial Plexus Injury?
Symptoms can vary greatly, based on the location and severity of the injury. In most cases, only one arm will be affected.
For less severe, minor injuries (often called stingers or burners) symptoms can include:
- Numbness and weakness in the arm
- An electric shock-like or burning sensation that shoots down the arm
For the most part, these symptoms last only a few seconds to minutes, but in some cases, the symptoms may last for days or longer.
For more severe injuries (those that severely hurt or tear or rupture the nerves), symptoms can include:
- Severe pain
- Weakness or inability to use certain muscles in the shoulder, arm, or hand
- Total lack of movement and feeling in the shoulder, arm, and hand
- An arm that hangs limply
Many brachial plexus injuries heal with time, leaving little lasting damage. However, some injuries cause temporary or permanent complications, which can include:
- Pain resulting from nerve damage, which may become chronic
- Stiff joints
- Muscle atrophy
- Numbness
- Permanent disability, including muscle weakness or paralysis
Some brachial plexus injuries can result in a disorder called Horner’s syndrome. In this syndrome, certain nerves in the sympathetic nervous system are damage, leading to drooping eyelid, an overly constricted pupil, and decreased facial sweating on one side of the face.
What Causes Brachial Plexus Injuries?
Damage to the upper nerves of the brachial plexus occurs when the shoulder is forced down while the neck stretches up and away from the shoulder. Damage to the lower nerves of the brachial plexus occurs when the arm is forced above the head. Injuries such as these can happen in numerous ways, including:
- Trauma, such as automobile accidents or serious falls
- Contact sports
- Tumors and cancer treatments
- Difficult births
How are Brachial Plexus Injuries Diagnosed?
Physicians will often turn to certain tests to diagnose brachial plexus injuries, including:
- X-rays
- EMG (electromyography)
- Nerve conduction studies
- MRI
- CT scans
What is the Treatment for a Brachial Plexus Injury?
Treatment will vary based on severity, type/location of the injury, any other conditions, and the length of time that has passed since the injury. Nerves that have only been stretched may not need further treatment and may recover on their own. Other treatments include:
- Physical therapy
- Occupational therapy
- Corticosteroid creams or injections
- Medications for pain management
- Surgery
There are several types of surgery that may be used when treating brachial plexus injuries, including:
- Muscle transfer
- Nerve transfer
- Nerve graft
- Neurolysis
It can take up to three years for pain from the most severe cases to resolve. Providers may also use a surgical procedure to interrupt pain signals coming from the damaged part of the spinal cord.
A brachial plexus injury can interfere with an individual’s ability to work or carry out daily tasks. If you have been diagnosed with a brachial plexus injury and are worried that it may be impeding your ability to continue to safely practice on patients, you should speak with an experienced disability insurance attorney.
These posts are for informative purposes only and should not be used as a substitute for consultation with and diagnosis by a medical professional. If you are experiencing any of the symptoms described above and have yet to consult with a doctor, do not use this resource to self-diagnose. Please contact your doctor immediately and schedule an appointment to be evaluated for your symptoms.
Sources
Mayo Clinic
John Hopkins
National Institute of Health
Cleveland Clinic
