A brachial plexus injury is damage to the network of nerves that originate from the spinal cord in the neck and control movement and sensation in the shoulder, arm, and hand. The brachial plexus is formed by the intertwining of the ventral rami of the lower cervical and first thoracic nerve roots (C5-T1).

Common Symptoms

The most common symptoms include:

• Muscle weakness or paralysis in the shoulder, arm, and hand
• Numbness or loss of sensation in the arm and hand
• Intense pain

Cause & Anatomy

Brachial plexus injuries can occur due to:

• Trauma (e.g., motor vehicle accidents, falls, sports injuries) causing stretching, tearing, or avulsion of the nerves
• Birth injuries during difficult deliveries, especially with larger babies
• Tumors or cancer treatments like radiation therapy compressing the nerves
• Inflammation or other medical conditions affecting the nerves

The brachial plexus is a network of intertwined nerves branching from the spinal cord’s ventral rami of C5-T1. It controls movement and sensation in the shoulder, arm, and hand. Each nerve root has specific functions, so the location and type of injury determine the symptoms.

Diagnosis

• Physical examination to assess mobility, strength, and sensation
• Imaging tests like X-rays, CT, or MRI scans to visualize the injury
• Electromyography to measure nerve activity in the muscles

Prevention

While not all injuries are preventable, using proper safety equipment in sports, being cautious during high-risk activities, and ensuring safe delivery practices for newborns can reduce the risk.

Treatment

Treatment depends on the severity but may include:

• Physical therapy and exercises to maintain mobility
• Medications for pain management
• Surgery to repair torn nerves or grafts for avulsed nerves

Surgery

Common surgical procedures include:

• Nerve repair (neurorrhaphy) to rejoin torn nerve ends
• Nerve grafting using expendable sensory nerves to bridge gaps
• Nerve transfers using nearby uninjured nerves
• Muscle transfers to restore function

Rehabilitation After Surgery

Rehabilitation is crucial after surgical repair and may involve:

• Exercise therapy to regain strength and range of motion
• Sensory retraining techniques
• Neuromuscular electrical stimulation
• Splinting and bracing to maintain proper positioning
• Psychological support for coping with disability

FAQ’s

Can a brachial plexus injury heal on its own?
Minor injuries may heal spontaneously, but severe injuries often require surgical intervention for functional recovery.

How long does it take to recover from a brachial plexus injury?
Recovery time varies based on injury severity but can take months to years, especially for surgical repairs as nerve regeneration is slow.

What are the long-term effects of a brachial plexus injury?
Potential long-term effects include chronic pain, muscle atrophy, joint stiffness, and permanent disability or paralysis if the injury is severe.