Brachial Plexus Injuries

What is a Brachial Plexus Injury?

A brachial plexus injury is a condition characterized by injury or damage to the brachial plexus, a network of nerves that emerges from the spinal cord in the neck region. The brachial plexus enables the movement of the muscles in the arms and shoulders and sensation in the overlying skin.

Causes of a Brachial Plexus Injury

Brachial plexus injuries are mainly caused by the compression or stretching of the brachial plexus nerves. Some of the more common causative factors include:

• Falls from heights
• Motor vehicle accidents
• Cancers or tumors
• Wounds from sharp objects
• Excessive bleeding
• Gunshot wounds
• Difficult births
• Spinal cord injuries
• Contact sports injuries

Symptoms of a Brachial Plexus Injury

Symptoms of a brachial plexus injury vary based on the site of injury and severity of the condition. These include:

• Loss of sensation
• Pain
• Numbness in the arms and shoulder
• Burning sensation
• Weakness
• Loss of movement

Diagnosis of a Brachial Plexus Injury

Your doctor will review your medical history and symptoms, and perform a physical examination of your arms and shoulder to assess function and sensation. Some common tests that may be ordered to confirm a diagnosis include the following:

• X-ray: High electromagnetic energy beams are used to produce images of the bones in the shoulder and neck
• CT scan: Involves the use of a special rotating x-ray machine to produce highly detailed cross-sectional images of the brachial plexus region
• Nerve block: An injection of an anesthetic and steroid medication around the spinal nerve root to determine the source of pain
• MRI Scan: An imaging study that uses a large magnetic field and radio waves to detect any damage to the soft tissues
• Electromyography: This process involves the use of small electrodes inserted into the muscles to record electrical activity

Treatment for Brachial Plexus Injury

Treatment for a brachial plexus injury is based on the severity of the condition. Nonsurgical treatments include:

• Rest: In cases of minor injuries, avoiding activities that may exacerbate symptoms and resting the area may be enough to heal the condition.
• Physical therapy: Your doctor will recommend special exercises and other techniques to improve flexibility and movement of the joints and muscles in the shoulder and neck.

If non-conservative treatment methods are unsuccessful, your doctor may recommend surgery to be performed within six months after the injury, as this improves the likelihood of a positive outcome. The various surgical procedures include:

• Neurolysis: Chemical agents are injected into nerve fibers to reduce nerve pain by destroying the damaged sensory nerves.
• Nerve graft: The injured part of the nerve is removed and replaced with a nerve from another part of your body.
• Muscle transfer: Your doctor will remove a tendon or muscle from the thigh to replace the injured part in the neck region.