Brachial Plexus Injury: Symptoms, Treatment and Surgery

Brachial plexus is a complex network of nerves which are intertwined and together send signals to control the overall movement and sensations in the shoulder, arms and hands. These nerves provide support to the arms exiting the spinal column high in the neck and also the ones that aid the hands and fingers while exiting from the lower end of the neck.

A brachial plexus injury occurs when this network of nerves is stretched, compressed or ripped apart from the spinal cord, in severe cases. The former two types are minor brachial injuries which are known as stingers or burners and are commonly found in sports persons especially footballers. However, in some cases, babies might also have minor brachial plexus injuries at birth. Conditions such as tumour and inflammation in these nerves can also cause brachial plexus injury. A severe form of this injury which could result in the network being completely torn away is caused by a road accident. In such cases, the person can also become permanently paralyzed from the arm or could lose most of the function and sensation.

Symptoms of Brachial Plexus Injury

The symptoms of a brachial plexus injury can vary from person-to-person depending on the severity of the condition and the location of the injury. However, in most cases, only one arm is affected.

Minor Injuries

Minor brachial plexus injuries are often caused due to sports activities such as football, wrestling, etc. which tend to compress or overtly stretch the network of the nerves. These minor injuries are called stinger or burners and can cause the following symptoms:

  • Electric shock sensations in the arm
  • Burning sensations in the arm
  • Numbness in the arm
  • Acute weakness in the arm

The duration of the symptoms depends on the depth of damage. It could last from several seconds to a few days or even longer.

Severe Injuries

A severe form of brachial plexus injury i=occurs when the entire network is shredded and torn apart. Even in this case, the most severe form occurs when the nerve root is detached from the spinal cord. This form is medically referred to as avulsion.

Symptoms of severe brachial plexus injury include:

  • Weakness in the arm, hand or shoulder
  • Complete loss of function or inability to use the arm, shoulder or hand
  • Loss of feeling or sensations in the arm, hand or shoulder
  • Extreme and unexplained pain in the arm, hand or shoulder

One must immediately seek medical care, in case of the following:

  • Frequent burners or stingers
  • Weakness or loss of feeling in the arm, hand or shoulder
  • Extreme neck pain
  • Symptoms persist in both arms together or one-by-one

Treatment of Brachial Plexus Injury

The treatment type for brachial plexus injury depends on the type of injury, the severity of the injury, the time duration since the injury and the location of the injury.

In some cases, where the nerves have only been temporarily strained or stretched, no form of treatment may be required since they will naturally heal. However, in some slightly intense cases then these, physical therapy, special exercises may be recommended to improve joint and muscle function, maintain a healthy range of motion and also prevent stiffness in joints.

That said, in severe cases, surgery may be the only form of treatment to repair the brachial plexus network. The surgery should be performed within 6-7 months post the injury; any delay than this period could lower the effectiveness and also can result in lower success.

On the other hand, to analyze the impact of the surgery, one must wait for several years since the nerve tissue takes some time to grow back into form. During the recovery period, the recommended exercises, diet and precautions must be taken strictly to ensure full function restoration.

Types of Surgery for Brachial Plexus Injury

Nerve Grafting: In this surgical method, the surgeon removes the damaged or compromised part of the nerve network and replaces it with sections of healthy nerves from other body parts. This helps to restore function but could take a lot of time for a full recovery.

Nerve Transfer: In this type of surgery, the surgeon prioritizes the functioning of the nerves and hence, takes a more important but not functioning nerve and connects it with a less important but properly functioning nerve to restore the arm function. This is mostly done when the nerve root is torn apart from the spinal cord.

Muscle Transfer: In this surgical method, the surgeon takes a healthy, functioning but less important muscle from another body part – such as the thigh – and places it in the arm while forming reconnections with the nerves and blood vessels of the arm to supply the muscle.

Pain Management

The most important aspect of brachial injury is to manage and minimise the pain. The pain caused because of brachial plexus injury is often extremely intense like a constant burning or crushing pain. The pain could take about 2-3 years to go in most cases, even after surgical treatment. The doctor might recommend certain pain killers or other medications to provide relief temporarily. In some cases, the doctor might perform surgery to severe the connection the sends pain signals from the affected spinal cord area.

In all, a brachial plexus injury can be effectively treated provided adequate medical treatment is received. Minor cases are simpler to treat and have shown more success rates as compared to severe cases where the entire network has been destroyed. That said, the best advice should be taken from a certified doctor.