Overview
A brachial plexus injury is a condition in which the network of nerves that sends signals from the spinal cord to the shoulder, arm, and hand is stretched, compressed, or in more severe cases, torn apart from the spinal cord. This injury can result from various factors, such as contact sports, difficult births, trauma, tumors, or cancer treatments. Symptoms can range from mild electric shock-like sensations and numbness to severe paralysis, depending on the severity and location of the injury. The most severe brachial plexus injuries often occur from motor vehicle or motorcycle accidents.
Understanding the disease
Symptoms
The symptoms of a brachial plexus injury can vary depending on the severity and location of the injury. Typically, only one arm is affected. For less-severe injuries, also known as stingers or burners, symptoms may include:
- A feeling like an electric shock or a burning sensation shooting down the arm
- Numbness and weakness in the arm These symptoms usually last for only a few seconds or minutes but may persist for days or longer in some cases. More-severe injuries can cause symptoms such as:
- Weakness or inability to use certain muscles in the hand, arm, or shoulder
- Complete lack of movement and feeling in the arm, including the shoulder and hand
- Severe pain It is important to see a healthcare provider if you experience recurrent burners and stingers, weakness in the hand or arm, neck pain, or symptoms in both arms.
Risk Factors
Risk factors for developing brachial plexus injury include participating in contact sports such as football and wrestling, as well as being involved in high-speed motor-vehicle accidents. Other factors may include difficult births, particularly in cases of high birth weight, breech presentation, or prolonged labor, and trauma from accidents such as motorcycle accidents, falls, or bullet wounds.
Development
Brachial plexus injuries can occur in several ways, including:
- Contact sports: Many football players experience burners or stingers, which can occur when the nerves in the brachial plexus get stretched beyond their limit during collisions with other players.
- Difficult births: Newborns can sustain brachial plexus injuries. These may be associated with high birth weight, breech presentation, or prolonged labor. If an infant's shoulders get wedged within the birth canal, there is an increased risk of a brachial plexus palsy. Most often, the upper nerves are injured, a condition called Erb's palsy.
- Trauma: Several types of trauma, including motor vehicle accidents, motorcycle accidents, falls, or bullet wounds, can result in brachial plexus injuries. Severe brachial plexus injuries can leave the arm paralyzed, but surgery may help restore function.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect a brachial plexus injury if you experience any of the following:
- Recurrent burners and stingers
- Weakness in the hand or arm
- Neck pain
- Symptoms in both arms These symptoms can indicate damage to the upper nerves that make up the brachial plexus, which may require medical care. Even minor brachial plexus injuries can cause permanent weakness or disability, so seeking medical attention is important to ensure proper diagnosis, treatment, and recovery.
Diagnosis
To diagnose a brachial plexus injury, a healthcare provider will review your symptoms and conduct a physical examination. Additionally, one or more of the following tests may be performed:
- X-ray: This can help identify any fractures or associated injuries in the shoulder and neck area.
- Electromyography (EMG): During an EMG, a needle electrode is inserted into various muscles to evaluate the electrical activity of the muscles when they contract and at rest. This test can help determine the extent and severity of the brachial plexus injury. It's important to prepare for any necessary tests by informing your healthcare provider of any medications, vitamins, or supplements you're taking, and by writing down your symptoms, the time of injury, and any changes you've noticed in your condition. Don't hesitate to ask questions and discuss all available treatment options with your provider.
Management and Treatment
Complications
Potential complications of a brachial plexus injury include stiff joints, pain, numbness, muscle atrophy, and a higher risk of future injury. In some cases, the injury may result in temporary or permanent disability, depending on factors such as the severity, location, and age of the individual.
Prevention
While damage to the brachial plexus often cannot be prevented, you can take steps to reduce the risk of complications once an injury has occurred. To prevent complications, perform daily range-of-motion exercises and attend physical therapy if you temporarily lose the use of the hand or arm. Avoid burns or cuts if you are experiencing numbness. If you are an athlete, consider wearing specific padding to protect the brachial plexus area during sports. To reduce the risk of trauma, avoid high-impact activities and wear appropriate protective gear during sports or activities that carry a risk of injury.
Home Remedies
It is important to consult with a healthcare provider for proper evaluation, treatment, and recovery recommendations for a brachial plexus injury.
Treatment
Treatments for brachial plexus injury depend on the severity and location of the injury. For minor injuries, such as stingers or burners, rest, ice, and over-the-counter pain relievers are often recommended. More severe injuries may require physical therapy, surgery, or a combination of both. Surgery is often considered for severe brachial plexus injuries, especially when the nerve damage is extensive or permanent. The goal of surgery is to repair or reconnect the damaged nerves, although the outcome may vary. In some cases, nerve transfer surgery may be necessary, where a working nerve is transplanted from another area of the body to restore function to the affected limb. Physical therapy plays a crucial role in the recovery process, helping to improve range of motion, strength, and overall function. It may involve exercises to help regain muscle strength, as well as techniques to manage pain and prevent further complications. In cases where the injury is due to tumors or cancer treatments, the primary treatment is focused on addressing the underlying condition. Surgical removal of tumors or radiation therapy may be necessary to alleviate the pressure on the affected nerves. It's important to consult with a healthcare professional for a proper evaluation and personalized treatment plan based on the specific circumstances of the brachial plexus injury.
Preparing for medical consultation
To prepare for an appointment for a brachial plexus injury, you may need to:
- Write down your symptoms, including how you were injured, how long you've had your symptoms, and whether they've gotten worse over time.
- Make a list of all medications, vitamins, and supplements that you're taking.
- Ask any questions you may have about the injury, diagnosis, or treatment options. Be sure to inquire about the different possibilities available to you.
- Find out if there are any specific preparations needed for tests, such as stopping certain medications or avoiding lotions on the day of the test. Remember to bring a family member or friend along to the appointment, as they can help absorb information and remember details that you may forget.