A group of nerves that send signals between the spinal cord and the shoulder, arm, and hand is called the brachial plexus. Injury to these nerves usually occurs when the nerves are stretched, squeezed together, or ripped apart from the spinal cord (the most severe case).
Mild brachial plexus injuries (also known as stingers or burners) often occur in contact sports (such as football). Sometimes, babies may also develop this condition when they are born. Furthermore, tumors, inflammation, and other health problems may affect the brachial plexus.
One of the most severe type of brachial plexus injuries occur during motorcycle or car accidents. Therefore, people may experience paralysis of the arm or hand. However, even in severe cases, the condition can be treated with surgery.
Symptoms
The symptoms that appear in people with this condition are different because they depend on the severity and location of the brachial plexus injury. For instance, some people may notice that only one arm is affected.
Mild Injuries
Mild forms of this condition often happen due to contact sports (including wrestling, football, and others). When these nerves get squeezed together or stretched, the symptoms include a feeling like an electric shock or a burning sensation down the arm, numbness, and weakness in the arm.
Previous symptoms usually last at least several seconds or minutes, but in some people, the symptoms may persist for days or even weeks.
Severe Injuries
Severe symptoms usually occur when an injury causes serious damage, tears, or even ruptures of the nerves. The most severe form of brachial plexus injury happens when the nerve root is cut or torn from the spinal cord. Check below some symptoms that often occur after serious injuries:
- Severe muscle weakness
- Loss of feeling in the arm (including the hand and shoulder)
- Severe and long-lasting pain
Immediately visit your healthcare professional if weakness or disability lasts more than a few weeks or if you experience the following symptoms. Examples include:
- Neck pain
- Symptoms appear in both arms
- Severe weakness
- Stingers and burners continue to appear even after a few days
Causes
Injury to the brachial plexus in the upper nerves often happens when the shoulder is forced down while the head is pushed to the opposite side. The lower nerves may get damaged when the arm is forced above the head. Check below some causes of brachial plexus injury:
- Contact sports – In most cases, football players develop brachial plexus injuries because the nerves are stretched beyond their limit.
- Birth – Some babies may develop injuries to the brachial plexus during delivery. It mostly occurs in babies with a high birth weight, a very long labor, and breech.
- Injuries – These include motor vehicle accidents, motorcycle accidents, bullet wounds, falls, and others.
- Tumors and cancer treatments – Tumors are specific masses that may cause nerve damage because they can grow large enough to put pressure on specific nerves in the body. In some cases, people get brachial plexus injuries due to neurofibromatosis or after radiation therapy (a treatment used to destroy cancer cells throughout the body).
Risk Factors
Motorcycle or car accidents and contact sports are the bigger risk factors for brachial plexus injuries.
What Are The Potential Complications of Brachial Plexus Injury?
While mild injuries of the brachial plexus heal themselves, some injuries require treatment and may cause complications. Check some examples below:
- Joint stiffness – Healthcare providers may recommend physical therapy if you temporarily cannot move the arm or hand because it may lead to joint stiffness.
- Pain – This complication occurs due to nerve damage and can sometimes be lifelong.
- Numbness – The risk of self-harm and burning significantly increases if you lose feeling in the arm or hand.
- Muscle atrophy – While nerves repair themselves, it is a slow process that may take years. If you are not using the affected muscles during this time, it may lead to muscle atrophy.
- Permanent disability – There are multiple factors that affect recovery from a serious brachial plexus injury. These include your age, type, location, and severity of the injury, and others. Sometimes, people have muscle weakness or paralysis for the rest of their lives despite surgery that repairs the nerves.
How to Prevent Brachial Plexus Injury?
Unfortunately, injuries to the brachial plexus cannot always be avoided. Anyway, you can take some steps to reduce the risk. Examples include:
- Physical therapy – This therapy can help prevent joint stiffness if you temporarily cannot use the arm or hand.
- Avoid burns or cuts to prevent numbness
- If your child develops brachial plexus injuries, you should exercise his/her muscles and joints every day. Otherwise, it may lead to permanent joint stiffness.
Diagnosis
Diagnosis of this condition involves a physical examination, tests, and questions about the symptoms and medical history. Check below some tests used to confirm the condition:
- X-ray – This is an imaging test used to get images of different body structures and organs. It helps identify neck and shoulder fractures.
- Electromyography (EMG) – This test involves an electrode that is inserted into muscles through the skin. It helps measure the electrical activity of the muscles during rest or physical activity.
- Nerve conduction study – It is usually performed along with EMG and involves measurement of how fast and how well the electrical signals move between nerves. It helps determine how well specific nerves work.
- Magnetic resonance imaging (MRI) – This is another imaging test that uses a magnetic field and radio waves to make detailed images of multiple tissues and organs in the body. It may show damage caused by brachial plexus injuries as well as artery damage.
- Computerized tomography (CT) myelography – This test uses contrast dye to produce cross-sectional images of the body.
Treatment
Treatment for people with a brachial plexus injury is different because it depends on multiple factors. For example, the severity and location of the injury, overall health, your age, and preferences. Moreover, some nerves that have been stretched only may heal themselves. One treatment that doctors usually recommend for all people with brachial plexus injuries is physical therapy. It helps prevent permanent joint stiffness that may occur due to temporary inability to move an arm or hand.
The most effective treatment for severe cases is surgery. In some cases, the surgery can be delayed to check if the nerves does not heal themselves. Unfortunately, some recent studies have shown that delaying surgery for more than 2 to 6 months reduces the chances of successful repair.
While nerve tissue recovers on its own, this is a long-term process that may take years even with surgery.
Types of Surgery
- Neurolysis – It is used to remove scar tissue from the affected nerves.
- Nerve repair – During this procedure, surgeons will repair the injured nerves.
- Nerve graft – This surgery uses nerves from other body parts to replace the damaged ones.
- Nerve transfer – This treatment is often recommended for people with severe brachial plexus injuries. During this procedure, surgeons will connect a less important nerve that works with a more important nerve that does not work. It helps a new nerve to grow.
- Muscle transfer – This treatment involves a tendon that is removed from one body part and placed in the affected part.
Pain Relievers
Severe pain may occur in people with serious brachial plexus injuries. Therefore, physicians may prescribe some medicines or some procedures that help control pain.
Frequently Asked Questions
What is the new treatment for brachial plexus injury?
This is an effective treatment that involves nerves from other body parts to replace the damaged ones. It is called a nerve graft, and it helps make a bridge for new nerve growth over time.
What are the red flags for a brachial plexus injury?
These include:
- Numbness
- Loss of feeling in the arm or hand
- Inability to control or move the shoulder, arm, wrist, or hand
Go to the nearest emergency room or call 911 in the U.S. if any of the previous symptoms occur.
What happens if brachial plexus injury is left untreated?
People with injuries of the brachial plexus may experience some complications, especially without treatment. Check some examples below:
- Chronic and severe pain
- Numbness, weakness, or paralysis
- Muscle atrophy
- Permanent joint stiffness or disability
- Developmental problems
- Scoliosis
- Contractures
Ask your healthcare provider if you have additional questions.
