A brachial plexus injury affects the nerves responsible for communication between the spine and the arms, shoulders, and hand. Such an injury occurs when the nerves in this location are stretched or torn. This usually results when the shoulder is forced down and the neck stretches up as may happen when the arm is forced above the head. A brachial plexus injury commonly occurs during contact sports or a vehicular accident, but may also result from other traumatic injury, a difficult birth or a tumor. Usually only one arm is affected. Rarely, brachial plexus injury occurs because of inflammation unaccompanied by shoulder injury, a condition known as Parsonage-Turner syndrome or brachial plexitis.
Symptoms of a Brachial Plexus Injury
Depending on the severity of the brachial plexus injury, the symptoms may vary a great deal in intensity and duration. Patients with mild brachial plexus injuries have usually endured stretched nerves. These patients typically experience weakness, numbness, or a burning sensation in the arm that only lasts a short time, from several minutes to several days. If the nerves are torn or ruptured during the injury, however, much more severe symptoms occur and persist. These symptoms may include:
- Intense pain
- Inability to use the fingers
- Inability to use the arm
- Complete lack of sensation in shoulder, arm and hand
The most serious brachial plexus injury is an avulsion, which occurs when the nerve root is disconnected from the spinal cord.
Diagnosing a Brachial Plexus Injury
A brachial plexus injury is diagnosed through a physical examination and a number of diagnostic tests to evaluate nerve-muscle contractions, assess the speed of electrical impulses, and visualize the spine and nerve roots. These tests may include:
- Lumbar Puncture (spinal tap)
- Electromyography (EMG)
- CT myelography
- Nerve conduction studies
Treatment for a Brachial Plexus Injury
Treatment for a brachial plexus injury varies depending on the severity of the condition. Patients who have suffered only mild injuries may be able to heal on their own, although pain medication is usually necessary. If the injury is more severe, surgery may be required. Depending on the particular injury, the neurosurgeon may perform a nerve graft or a nerve transfer. In either case, a healthy nerve is made to take over the function of the nerve that is damaged. In some situations, a transfer of muscle tissue may also be required if the muscle has deteriorated. Because a severe brachial plexus injury can be extremely painful, opioid medication is normally prescribed. Transcutaneous electrical nerve stimulation (TENS) is also sometimes prescribed for pain management.