Brachial Plexus Injuries

The brachial plexus is the nerve network that transmits signals from spinal cord to shoulder, arm and hand. A brachial plexus injury happens when these nerves are damaged – stretched, compressed, in severe cases, get ripped apart or torn away from the spinal cord.

Minor brachial plexus injuries are called stingers or burners, common in contact sports such as wrestling and football. Babies may also sustain brachial plexus injury at the time of birth. Inflammation and tumours are other conditions that may cause damage to the brachial plexus network of nerves.

Auto or motorcycle accidents account for most severe brachial plexus injuries. Severe brachial plexus injuries can paralyse your arm with complete loss of function and sensation. Nerve grafts, nerve transfers or muscle transfers are done surgically to restore function.

Symptoms Of Brachial Plexus Injuries

Brachial plexus injury symptoms can vary, depending on the chronicity and location of the injury. Generally only one arm is affected.

LESS SEVERE INJURIES

As contact sports like football and wrestling are played vigorously minor damage can happen to brachial plexus. The brachial plexus nerves can get stretched or compressed. These are called stingers or burners and can give rise to the following symptoms:

1. A feeling like an electric shock or a burning sensation shooting down your armNumbness and weakness in your arm.

2. Generally these symptoms go off in a matter of minutes, but in rare cases it may last for quite some time, like days.

MORE SEVERE INJURIES

More severe symptoms arise out of injuries that tear or rupture the network of nerves. The most severe brachial plexus damage happens when the nerve root is ruptured from the spinal cord.

Signs and symptoms of more severe injuries include:

1. Certain muscles in your hand, arm or shoulder feel weak and you will find it extremely difficult to use them

2. Complete lack of movement of your shoulder and hand

3. Severe pain

Brachial plexus injury may lead to permanent weakness or disability. Even if it may appear minor, consult your doctor if you have:

1. Persistent stingers or burners

2. Prolonged arm or hand weakness

3. Neck pain

4. Symptoms in both arms

What Causes Brachial Plexus Injuries?

Brachial plexus injury can happen in many ways, including:

CONTACT SPORTS – Many soccer players experience symptoms like stingers and burners. It happens when the brachial plexus nerves get stretched beyond their limit during collision with other players.

DIFFICULT BIRTH – Newborns can suffer from brachial plexus injuries. High birth weight, breech presentation or prolonged labour can account for this. If the baby’s shoulders get wedged within the birth canal, there is an increased incidence of brachial nerve palsy. Generally the upper nerves are damaged.

TRAUMA – Number of trauma, including motor vehicle and motor cycle accidents, falls or bullet wounds can lead to brachial plexus injury.

TUMOURS AND CANCER TRATEMENTS – Tumours can grow in the area of brachial plexus. Moreover, they can put pressure on the brachial plexus. Apart from that, when the chest area undergoes radiation treatment there is a chance of brachial plexus damage.

With time many brachial plexus injuries in both adults and children heal without any lasting damage. Having said that, all brachial plexus injuries should not be taken lightly as some may cause temporary or permanent problems such as:

STIFF JOINTS – Joints can stiffen due to paralysis of the hand or arm. This can make movement very difficult though you may eventually regain full range of motion. Because of this, your physician may recommend physiotherapy during your recovery phase.

PAIN – Pain arises out of nerve damage and it can be chronic.

NUMBNESS – If you feel your hand or arm numb, you may burn or injure yourself without even realising it.

MUSCLE ATROPHY – Nerve regeneration takes time. In some cases it can take even years to heal completely. During that time the affected muscle may degenerate due to lack of use.

PERMANENT DISABILITY –Your recovery from a brachial plexus injury depends on a number of factors, including your age, location, severity of injury. In rare cases even with surgery people ends up with permanent muscle weakness or paralysis.

Can We Prevent Brachial Plexus Injuries?

Ironically, brachial plexus injuries cannot be averted, but if you suspect of having a brachial plexus injury you can take some steps to mimimise the complications arising out of it.

If you temporarily lose your arm and hand functions, daily physiotherapy and range of motion exercises can help keep your joints supple. Be vigilant when you are near a heat body or sharp objects as you may not feel them as you are experiencing numbness. If you are an avid sports person who has a previous history of brachial plexus injury, your physician may suggest the use of protective padding over the area of the injury during sports.

If you are a parent of a child who is suffering from brachial plexus injury, it is important that you regularly exercise the child’s joints and muscles. This can be done when the baby is just a few weeks’ old. This helps prevent stiffening of the joints and your child’s muscles get strong and healthy.

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Q and As Brachial Plexus Injury

What are the symptoms of brachial plexus injury?

The brachial plexus is a network of nerves that sends signals from the spinal cord to the shoulder, arm, and hand. A brachial plexus injury occurs when these nerves are damaged. It can happen if the nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord.

The symptoms vary depending on the severity of the injury.

Less severe injury occurs when there is minor damage that occurs during contact sports when the brachial plexus nerves get stretched or compressed. The symptoms seen are a feeling like an electric shock or a burning sensation shooting down the affected arm, or there may be numbness and weakness in the arm. These symptoms usually last only a few seconds or minutes, but in some people, the symptoms may linger for days or longer.

In case of more severe injury, the symptoms result from injuries that seriously injure or even tear or rupture the nerves. The most serious brachial plexus injury occurs when the nerve root is torn from the spinal cord. Symptoms seen are:

Weakness or inability to use certain muscles in the hand, arm, or shoulder.
There can be a complete lack of movement and feeling in the arm, including the shoulder and hand.
There can be severe pain.

What causes brachial plexus injury?

When the shoulder is forced down while the neck is stretched up and away from the injured shoulder, there is damage to the upper nerves that make up the brachial plexus. The lower nerves are more likely to be injured when the arm is forced above the head. There are several causes for a brachial plexus injury. Such as:

Contact sports like rugby or wrestling.
Difficult birth – If the infant’s shoulders get wedged between the walls of the birth canal, there is an increased risk for brachial plexus injury.
Trauma like road traffic accidents.
Tumors and radiation treatment.

Is brachial plexus injury reversible?

Most cases of brachial plexus injury are reversible if they are provided with the correct medication and physical therapy. Though, in some cases, despite proper care some form of pain, permanent muscles weakness, or paralysis.

How is brachial plexus injury diagnosed?

The doctor takes a history and reviews the symptoms, followed by a detailed physical examination to diagnose brachial plexus injury. Other tests that aid the diagnosis are X-rays (to rule out associated fractures), electromyography, Magnetic Resonance Imaging (MRI), nerve conduction study, etc.

What happens if a brachial plexus injury is left untreated?

In minor cases where there is only stretching of the nerves of the brachial plexus, there is not much treatment needed. It is advised to do some range-of-motion exercises to prevent stiff joints or muscle atrophy.

But severe cases may require surgery to repair or replace the damaged nerve. If such cases are left untreated, it can lead to severe chronic pain, muscle atrophy, numbness, and even permanent disability.