The brachial plexus is a bundle of nerves responsible for the movements of your arms, wrists, and hands. This network carries the sensory signals from the spinal cord to the arms. So, when a brachial plexus injury happens, you may experience weakness, pain, or lack of sensation in your arms or shoulders.
Brachial plexus injury also leads to problems in the movements of arms, wrists, or hands.
Here is an overview of the injury, its causes, symptoms, treatments, and more.
What Is Brachial Plexus Injury?
Pressure, stress, wounds, and trauma can injure the brachial plexus. Brachial plexus injury is a condition when the spinal cord cannot communicate with the arm. This happens when the brachial plexus nerves are wounded, cut, or damaged.
In brachial plexus injury, you may experience severe pain in your arm or shoulders, or you may completely lose sensation in your arm. Your hand may also become disabled if the severity of the injury is high.
The severity of brachial plexus injury differs from one person to another. Surgical and non-surgical treatments help restore the arm’s functionality and sensation. However, some people may suffer from permanent disabilities.
Types Of Brachial Plexus Injury
Brachial plexus injury is of different types based on the location of the injury in the brachial plexus and the severity of the condition.
| Type Of Brachial Plexus Injury | Details |
|---|---|
| Brachial Plexus Avulsion | The nerve root is completely separated from the spinal cordCaused by traumaCauses severe pain |
| Brachial Neuritis | Progressive disorder of brachial plexus nervesSevere pain in upper arm and shoulder, leading to weaknessLegs and diaphragm can also get affectedPossibly caused by autoimmune responses due to childbirth, infections, and injury. |
| Brachial Plexus Neuroma | Caused by an injury to nerve tissues due to surgeriesThe nerve grows scar tissue or neuroma to promote repair.This neuroma causes pain, resulting in a knot on one of the brachial plexus nerves. |
| Brachial Plexus Rupture | Powerful stretching causes tearing of the nervesIt makes arms, hands, or shoulders weak.It makes some muscles dysfunctional.Causes severe pain |
| Brachial Plexus Neuropraxia Or Stretch | Caused by compression or traction injuryIt can cause a burning or stinging sensation. |
What Are The Causes Of Brachial Plexus Injury?
From childbirth complications to trauma and wounds, there are many causes behind having this injury.
Let us know in detail.
Brachial Plexus Birth Injury
If a mother suffers from long labor or there is breech presentation while delivering the baby, the newborn can be a victim of brachial plexus injury.
This injury also happens when a baby’s birth weight is higher. Some other factors increasing the risks of a brachial plexus birth injury are:
- Maternal diabetes
- Difficult deliveries with external assistance
- Shoulder dystocia
- Big gestational size
When a newborn has an injury in brachial plexus, the upper nerves are usually injured. This injury is called Erb’s palsy.
If the lower brachial plexus is affected at birth, a lesser-known condition called Klumpke’s palsy occurs.
Playing Contact Sports
People who play football often have stretched brachial plexus nerves. This stretching happens because of collisions with other players.
Tumor And Cancer Treatments
One undergoing radiation treatment for cancer in the chest or neck may have growing tumors along the brachial plexus. The tumor may also pressurize the brachial plexus.
Trauma
Falls, vehicle accidents, bullet wounds, or knife wounds can cause brachial this injury.
Trauma can also happen due to medical injuries. If a nerve is cut during surgery, or there has been an injection administration or wrong positioning of the body during surgery, it can lead to brachial plexus injury.
What Are Brachial Plexus Injury Symptoms?
The symptoms will differ based on where the injury has occurred in your brachial plexus. If the patient with brachial plexus suffers from other injuries, the symptoms will change.
Nevertheless, here are the common symptoms of injury in brachial plexus.
- Pain
- Weakness or numbness
- Loss of sensation
- Paralysis or impaired movement
Brachial Plexus Injury Diagnosis
There are multiple methods to diagnose injury in brachial plexus. A doctor physically examines your arm and shoulder to check whether the muscles and nerves are functional and stable or not.
Along with physical assessments, the following diagnostic methods are used for the detection of brachial plexus injury.
- X-ray imaging of arms, neck, chest, and shoulders
- Computed tomographic or CT scan
- Electrodiagnostic studies to find out muscle signals and nerve conduction
What Are The Preventive Measures For Brachial Plexus Injury?
You cannot prevent brachial plexus injury. However, certain practices can help you manage the condition better after an injury.
If you cannot use or move the arm temporarily for this injury, you must do range-of-motion exercises as recommended by the doctor or a physical therapist. This will prevent joints from getting stiff.
An athlete with this injury must wear padding to stop the injury from getting worse.
If your child or infant has a brachial plexus injury, as a parent, you must ensure regular exercise of the muscles and joints.
Exercise will eliminate the chances of stiffness, and the joints and muscles will remain functional.
What Is Brachial Plexus Injury Treatment?
Based on the severity and complications of your injury, your doctor will recommend surgical or non-surgical treatments for you.
Non-surgical treatments are only effective when the injury is mild and the doctor thinks the nerve injuries can heal on their own.
Sometimes, doctors also delay the surgical procedure and suggest non-surgical treatments to monitor the progress.
Nevertheless, let’s have a detailed look at the surgical and non-surgical treatments for brachial plexus injury.
Brachial Plexus Injury Surgical Treatment
Surgical treatments are most effective for this injury. However, before choosing the surgical method, the doctor considers the recovery time, the condition of the patient who will undergo the surgery, and the criticality of the condition.
Before I talk about the surgical procedures to treat brachial plexus injury, I must give you a brief overview of how these factors play important factors in deciding your eligibility/ineligibility or complications in surgical treatments.
Check out the table below.
| Determining Factor | Impact On Surgical Treatment |
|---|---|
| Recovery | You have to keep several things in mind related to recovery before you undergo any surgical treatment for brachial plexus injury. Keep your goals and expectations realistic. Healing will take time, and though there will be improvements in your functionality, your arm may not be as functional as it was before the injury. You have to take the rehabilitation program very seriously. |
| Candidate To Undergo Surgery | Certain conditions make one ineligible for surgical treatments of brachial plexus injury. Those factors are: Very advanced age Existing medical conditions or other injuries Stiffness and contractures in the joints History of traumatic spinal cord or brain injury |
| Complications Related To The Surgery | Surgical treatments for brachial plexus injury can cause some difficulties. Further surgery will be required if the outcome of the first surgery is not satisfactory or if there is an infection. Brachial plexus injury surgeries are large reconstructive surgeries. So, risk factors like blood clotting, chronic pain, cardiac attack, stroke, and even death will always be there. |
Once the doctor finds you eligible for surgical treatment, any of the following approaches.
Tendon And Muscle Transfers
Delayed diagnosis and treatment of brachial plexus can lead to unsuccessful surgeries. So, when nerves are not successfully repaired or reconstructed after surgery, tendon and muscle transfers are done.
A tendon transfer is the process of cutting a tendon from a functioning muscle and stitching that into a muscle tendon that works no more. This is an effective method to rehabilitate motor functions.
Muscle transfer is also done to restore motor functions. In this method, a fully functional muscle from other parts of the body is moved with its nerves, artery, vein, and tendon. This muscle and all its components are moved to the damaged area.
Nerve Repair
The doctor will use the nerve repair method if there are deep cuts in your nerves. The surgeon attaches the two edges of an injured nerve.
Nerve Graft
Nerve grafting is done when your spinal cord still has a functional nerve stump. Grafting promotes healthy regrowth of the damaged nerves and restores the nerve signals so that paralyzed muscles become functional.
The doctor will collect a healthy nerve from any other part of your body and stitch that between the two ends of a damaged nerve.
The grafted nerve works as a support as the nerve ends regrow.
Nerve Transfer
Brachial plexus injury can make the nerve stumps in the neck completely dysfunctional. So, nerve grafts cannot be attached to them. Nerve transfer is done in this situation.
The doctor will cut a healthy donor nerve and connect it to the injured nerve so that the paralyzed muscle can receive signals.
Nerve transfer can happen in two ways. The doctor can connect the donor nerve close to the damaged muscle. The nerve can also be connected to the damaged nerve in the brachial plexus.
Brachial Plexus Injury Non-Surgical Treatment
If you have a mild brachial plexus injury, non-surgical treatments may be helpful in the treatment of your condition.
Doctors recommend a standalone non-surgical treatment or a combination of multiple methods for faster recovery.
Brachial Plexus Injury Exercises And Therapies
You cannot undermine the importance of home rehabilitation in recovery from brachial plexus injury.
Physical exercises and therapies are helpful to get rid of the stiffness in the muscles of your arm. With the alleviation of stiffness, your arm will be more flexible and functional.
Treatment With Assistive Devices
Assistive devices can offer proper support to the muscles in your arm and help in pain management and movement.
Common assistive devices used for the treatment of brachial plexus injury are:
- Braces
- Compression sleeves
- Splints
Pain Relieving Medications
If the pain is excruciating, the doctor will ask you to take some relieving medications. Oral medications or topical ointments can be of great help.
However, these medications should be only used under your doctor’s recommendation.
Occupational Therapy
If your muscles have become very weak and the pain or numbness is severe, occupational therapies can help.
In these therapies, you will need to work on your practical skills like putting on clothes, cooking, etc.
Corticosteroid Creams And Injections
Corticosteroid injections or creams are used for better pain management in brachial plexus injury.
However, the application of corticosteroid creams or injections cannot be a long-term treatment for brachial plexus injury.
If corticosteroid gets into your bloodstream, you may suffer from side effects like Cushing’s Syndrome. Children can also be victims of deceased growth if corticosteroid application is very high or longer.
The Takeaway
Injured nerves need time to heal, and nerve regeneration happens very slowly, with the regeneration rate being around 1mm per day. So, if you suffer from brachial plexus injury, you will likely recuperate slowly. Based on the severity of your injury, it may take months before you notice any significant improvement in your condition.
Regular physical therapies are important during recovery to prevent muscle contractures and atrophy. Proper checkups with your neurologist are also crucial for monitoring the healing process. Physical therapies and checkups are also important for better pain management.
Especially brachial plexus injury infant or brachial plexus injury in children needs more attention as the healing time can be longer in such cases. It may take more than two hours for complete recovery.
Brachial plexus injury is painful, and its treatments and management are difficult. However, proper diagnosis on time and the right treatments can ensure major improvements in the functionality of the injured or damaged nerves.
It’s great that more studies and advancements are going on for the treatment of brachial plexus injury. The advancements or new techniques in nerve repair and transfer and medications can promote better nerve regeneration and treatment of the injury.
Frequently Asked Questions (FAQs)
Erb’s palsy is a form of brachial plexus injury. The condition has got its name from Wilhelm Erb, the doctor who first discovered it.
Klumpke’s palsy or Klumpke’s paralysis happens when the spinal nerve network at the back of your neck and stretches to your arm is injured. This injury of the nerves leads to paralysis of your arm.
Klumpke’s paralysis occurs due to birth injuries, trauma in the shoulders or arm, or tumors in the lungs or shoulders.
If you are eager to know about brachial plexus injury dog, you must understand that it’s a severe condition. Dogs of larger breeds are prone to this injury.It is difficult for a dog to recover from a brachial plexus injury. Recovery is only possible when the neurological deficits are much less, or the dog’s prognosis is very fast.
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