Brachial Plexus Injuries

The brachial plexus is a system of nerves that carry signals from the spine to the shoulder, arm and hand. Brachial plexus injuries happen most frequently due to the shoulder being pressed in one direction while the head is pushed in another. This can cause the nerves to become torn or stretched. Stretched brachial plexus injuries are by far the most common.

It is not uncommon for this type of injury to occur during birth if the baby's shoulder becomes twisted or impacted. Infants who do not recover naturally within a six-month period usually require surgery. Injuries to the brachial plexus occur frequently in sports and other activities.

In the most serious of cases, the nerve itself is torn from the spinal cord. Symptoms of a brachial plexus tear or rupture may include:

• Paralysis in your arm
• Numbness
• Lack of motion in arm but able to move fingers
• Stinging or burning sensation down entire arm
• Severe Pain

The duration of these symptoms may last anywhere from a few seconds to a number of days.

A number of tests may be required in order to diagnose the severity of the brachial plexus injury. Treatment may include occupational therapy, physical therapy, and if necessary, surgery.

A brachial plexus injury is the result of trauma or impingement on the nerve network that serves your shoulder and arm. The brachial plexus is a mass of nerves that comes off of the spinal cord and runs underneath the clavicle on its way to provide movement and sensation to the hands and fingers.

It typically occurs when the shoulder is pressed down forcefully, and the head is pulled up and away from the shoulder. Although it is usually seen in newborns that were birthed through natural childbirth, it is common to see this injury in contact sports and trauma. At BASIC Spine, we know that brachial plexus injuries can be painful. We can perform surgery on the area to relieve pressure on the nerves, but we usually try more conservative measures first.

To that end, we have physical therapists and chiropractors in our practice that can assist you with exercises and adjustments. Should those methods fail, our world class neurosurgeons can assist you with more invasive measures.

Causes

Brachial plexus injuries are most common in contact sports, and in this context, they are often referred to as stingers or burners. They can make the arm feel like it is numb or in extreme pain. Contact sports cause these injuries because the nerves of the brachial plexus often get stretched out due to the contact. In severe cases, the nerve can break, and this will cause greater pain.

Other reasons that may cause a brachial plexus injury include traumatic births. When the shoulders are squeezed as the newborn comes down the birth canal, the nerves can become stretched out and painful.

Direct trauma, such as a car accident or fall, can also cause brachial plexus injuries. Finally, a condition known as Parsonage-Turner syndrome can cause the plexus to become inflamed with no insulting injury.

Symptoms

Symptoms of brachial plexus injuries depend on how severely the nerves are affected. In less severe cases, you may experience an electric shock feeling shooting down your arm, or you may feel burning.

In addition, you may have some numbness and weakness in your hand. Fortunately, these symptoms usually resolve on their own and do not require any further intervention.

More severe brachial plexus injuries have several symptoms that stingers do not. For instance, you may be able to use your fingers, but you cannot move your elbow, arm, and shoulder. Conversely, you may be able to use your arm, but you have trouble moving your fingers. This depends on what portion of the brachial plexus has been damaged.

In some cases, you may not have movement in your hand, arm, or shoulder, and it is usually accompanied by severe pain. You should see a doctor if you frequently get stingers, have difficulty moving part of your arm, or have any weakness following a trauma.

Treatments

Although an occasional minor stinger can heal on its own, sometimes surgery is necessary for this condition. If you have several stingers, they can heal with rest and rehabilitation, but they will often leave scar tissue that affects the nerves. This scar tissue may need to be surgically removed to restore feeling and movement in the affected arm.

For nerves that have been stretched too far or are severed, other surgical interventions may be necessary. One possible procedure is a nerve graft.

In this procedure, the damaged nerves are removed, and nerves from other places in the body are used to complete the connection. Another procedure is a nerve transfer.

This surgery is primarily used in cases where the nerve has torn off of the nerve root close to the spinal cord. Instead of rebuilding the nerve, the spinal surgeon will disconnect a less important nerve root and transfer the brachial plexus to the healthy root. This surgery requires years of recovery since nerve tissue grows so slowly, and you may need to wear a brace to protect your hand from curling inward.

At BASIC Spine, we are familiar with both types of surgery for severe brachial plexus injuries, and we have a dedicated staff of neurosurgeons who can inform you as to which procedure is best for you.

In addition, we have physical therapists and pain management professionals in our practice to manage every aspect of your condition and recovery.