Brachial Plexus Injury

The brachial plexus is a collection of nerves that carry messages between the spinal cord and the shoulder, arm, and hand. Imagine these nerves as electrical wires connecting your brain to your limbs. A brachial plexus injury happens when these wires are damaged. This damage can take several forms, from being stretched or compressed, to being completely torn away from the spinal cord.

Sometimes, these injuries are minor. They're often called "stingers" or "burners" and commonly occur in contact sports like football. Babies can also experience brachial plexus injuries during childbirth. Other medical problems, like infections or growths, can also sometimes affect these nerves.

More severe brachial plexus injuries are often caused by serious accidents, such as car or motorcycle crashes. These severe injuries can result in the arm becoming paralyzed. However, in many cases, surgery can help repair the damaged nerves and restore some function. The success of the surgery depends on the severity of the injury and the promptness of treatment.

The spinal cord is connected to nerves that branch out to different parts of the body. These connections are vital. Sometimes, these nerves can be damaged. There are different levels of severity in nerve damage.

One serious type of damage is an avulsion (A), where the nerve roots are completely separated from the spinal cord. Another severe injury is a rupture (C), where the nerve is torn in two. A less severe injury is stretching (B) of the nerve fibers. This stretching can happen without actually tearing the nerve.

Injuries to the brachial plexus—the network of nerves that control the arm and shoulder—can vary greatly. Usually, only one arm is affected.

Minor injuries, often called "stingers" or "burners," can occur during contact sports like football or wrestling. These injuries happen when the nerves in the brachial plexus are stretched or compressed. Common symptoms include:

• A sharp, electric-shock-like or burning sensation that travels down the arm.
• Numbness and weakness in the arm.

These minor symptoms typically disappear within a few seconds to minutes. However, in some cases, they might last for days or more.

More serious injuries happen when the nerves are severely damaged, torn, or ruptured. The most severe injury involves the nerve roots being severed from the spinal cord.

Signs of more serious brachial plexus injuries include:

• Difficulty using certain muscles in the hand, arm, or shoulder.
• Loss of feeling in the arm, including the shoulder and hand.
• Intense pain.

If you experience these symptoms, it's crucial to seek medical attention to determine the extent of the injury and get appropriate treatment.

Brachial plexus injuries can lead to long-term problems like weakness and difficulty using your arm or hand. Even if a brachial plexus injury seems minor, it's important to get medical attention. See your doctor if you have any of these issues:

• Recurring "burners" or "stingers," or symptoms that don't go away quickly: These are temporary nerve pinches, but if they happen often or last a long time, it's a sign something might be wrong. It's also important to see a doctor if you notice any changes in the feeling in your arm or hand, like numbness, tingling, or a strange sensation.

• Weakness in your hand or arm: If you feel weaker than usual when using your hand or arm, it could be a sign of nerve damage. This weakness might show up when lifting things, gripping objects, or performing everyday tasks.

• Neck pain: Pain in your neck can sometimes be related to brachial plexus problems. This pain could be a sign that the nerves in your neck are being affected.

• Symptoms in both arms: If you're experiencing problems in both your arms, it's crucial to seek medical attention right away. This could indicate a more serious underlying issue affecting the nerves that control both arms.

If you are concerned about any of these issues, don't hesitate to contact your healthcare provider for a proper diagnosis and treatment plan. Early diagnosis and intervention can often improve outcomes.

Brachial plexus injuries happen when nerves in the shoulder area get stretched or damaged. These injuries can affect the nerves that control movement and feeling in the arm and hand. There are two main types of brachial plexus injuries, affecting either the upper nerves or the lower nerves.

Upper nerve injuries (like Erb's palsy) are more likely to happen when the shoulder is pushed down and the head is pushed in the opposite direction. Imagine someone pulling your shoulder one way and your head the other. This forceful movement can stretch the upper nerves too much.

Lower nerve injuries are more likely when the arm is pulled or forced above the head.

These injuries can occur in different situations:

• Sports: In contact sports like football, a sudden, forceful collision can stretch the nerves in the shoulder region, causing a "burner" or "stinger." This happens when the nerves are stretched beyond their usual range of motion during a tackle or other physical contact.

• Birth: Babies can experience brachial plexus injuries during childbirth. This is more common in babies with a higher birth weight, or babies who are born in a breech position (bottom first). If a baby's shoulders get stuck in the birth canal during delivery, the nerves can be damaged. This is often an upper nerve injury, called Erb's palsy.

• Accidents: Various accidents, including car crashes, motorcycle accidents, falls, or even gunshot wounds, can damage the brachial plexus nerves. The force of the impact can stretch or tear the nerves.

• Medical Conditions: Less commonly, tumors (sometimes related to conditions like neurofibromatosis) or cancer treatments (like radiation therapy) can affect the brachial plexus nerves. In these cases, the nerves may be damaged by the tumor or the treatment itself.

It's important to note that these injuries can vary greatly in severity. The specific cause and the degree of injury will influence the recovery process. If you suspect a brachial plexus injury, it's crucial to seek prompt medical attention.

Participating in contact sports like football and wrestling, or experiencing a high-speed car crash, can raise the chances of a brachial plexus injury. This injury affects the nerves in the shoulder, arm, and hand. These nerves control movement and feeling in that area. So, activities with a lot of physical impact or collisions, and fast-moving car accidents, put you at a higher risk of harming these important nerves.

Many brachial plexus injuries, even mild ones, get better on their own. However, some injuries can cause problems that last a short time or a lifetime.

These problems can include:

• Stiff Joints: If you have trouble moving your arm or hand, the joints can become stiff and hard to use. This is common, even if you regain some movement. Physical therapy can help keep your joints flexible during recovery.

• Pain: Nerve damage from a brachial plexus injury can cause pain that may never go away completely.

• Numbness: Loss of feeling in your arm or hand puts you at risk of hurting yourself without noticing. For example, you might not feel heat or sharp objects.

• Muscle Weakness or Loss of Muscle (Atrophy): Nerves take time to heal, sometimes years. If you don't use your muscles regularly, they can weaken and shrink over time.

• Permanent Disability: How well someone recovers from a serious brachial plexus injury depends on many factors, such as their age, the type of injury, where it happened, and how severe it was. Even with surgery, some people may have lasting muscle weakness or paralysis. This means they might not be able to move parts of their arms or hands as well as they used to.

A brachial plexus injury, while not always preventable, can have its complications reduced. Here's how:

For Adults:

If you've injured your arm or hand and can't use it for a while, regular exercises to move your joints (range-of-motion exercises) and physical therapy are crucial. These help stop your joints from getting stiff. It's also important to be extra careful about burns and cuts, as you might not feel them if you have numbness in the affected area. If you're an athlete with a brachial plexus injury, your doctor might recommend wearing protective gear to shield the area during sports.

For Children:

If your child has brachial plexus palsy, daily exercises are vital to prevent joint stiffness and keep their muscles strong. These exercises can start even when your baby is a few weeks old. Moving the joints and muscles regularly is important to maintain flexibility and prevent them from becoming permanently stiff. This also keeps the working muscles healthy and strong. It's crucial to follow your child's doctor's advice on the specific exercises and frequency.

Important Note: The specific exercises and precautions should always be discussed and determined by your doctor or a qualified physical therapist. They can tailor a plan to your individual needs and circumstances.

To figure out what's wrong with you, your doctor will check your symptoms and do a physical exam. If they need to know how bad your brachial plexus injury is, they might use one or more of these tests:

X-rays: An X-ray of your shoulder and neck can show if there are any broken bones or other problems in those areas that might be related to the injury.

Electromyography (EMG): During an EMG, a doctor uses a thin needle to check the electrical activity in different muscles. The needle is inserted into the muscles. This test looks at how the muscles work when they contract and when they're relaxed. You might feel a little pinch or discomfort as the needles go in, but most people can tolerate it.

Nerve Conduction Studies: These tests often happen along with an EMG. They measure how quickly and efficiently electrical signals travel along the nerves. This helps show how well the nerves are working.

Magnetic Resonance Imaging (MRI): An MRI uses powerful magnets and radio waves to create detailed pictures of the inside of your body, including your organs and tissues. This is helpful to see the extent of damage to the brachial plexus after an injury. It can also show if there's any damage to the blood vessels in the affected limb, which is important for deciding how to treat the injury. There are advanced MRI techniques like magnetic resonance neurography or diffusion tensor imaging that provide even more detailed pictures.

Computed Tomography (CT) Myelography: A CT scan uses many X-rays to create detailed images of the body. CT myelography involves injecting a special dye into the spinal canal (during a spinal tap) to highlight the spinal cord and nerve roots. This test is sometimes used if an MRI doesn't give enough information about the injury. This test is often used to look for problems in the spinal cord and nerves.