Brachial Plexus Injury: Types, Signs, and Treatment – Healthline

Your brachial plexus is a network of nerves in your shoulder that branches into five major nerves in each arm. It carries signals from your spinal cord to your arms and hands, allowing you to move your arm, hands, and wrists. Sensory skin nerves are also part of the brachial plexus and allow you to feel temperature and other sensations.

There are several types of brachial plexus injuries, with many different causes. They also vary in severity, with some people healing completely on their own and others having permanent damage.

Read on to learn more about how brachial plexus injuries occur, what your treatment options are, and more.

The most common cause of a brachial plexus injury is some sort of trauma, such as:

In some cases, the trauma itself will cause the injury, such as a nerve rupture on impact from a fall. In other cases, a brachial plexus injury can be secondary to another injury, such as:

A newborn can also get a brachial plexus injury during childbirth.

There are four main types of brachial plexus injuries.

An avulsion is the most severe type of brachial plexus injury. Its when the root of your nerve separates from your spinal cord. These are usually due to severe trauma, such as a fall or motor vehicle accident.

Avulsion is often a permanent condition since surgery cant usually reattach the nerve. Injuries at or near the spinal cord usually cause more severe pain.

A rupture is also a tear in your nerve, but not at the spinal cord. It occurs when something causes your nerve to stretch to the point where it tears, either partially or fully.

Its less serious than an avulsion but still more serious than other types of brachial plexus injuries. Youll usually need surgery as soon as possible in order to recover.

Neurapraxia is when something stretches a nerve to the point of damage, but it doesnt tear. It usually causes a burning or stinging sensation. Often called burners or stingers, these are the mildest kind of brachial plexus injury.

Neurapraxia is often due to compressing the root of your nerve. This can happen when something pushes your head to one side.

It may also be due to traction, which is when the nerve gets pulled down. This is more common in people who play contact sports.

An injured nerve may form scar tissue as it heals. This scar tissue, called a neuroma, can interfere with the function of your nerve by putting stress on it and blocking signals.

Neuromas can be very painful. Surgery is necessary to remove the scar tissue.

Brachial plexus injuries are most common in males ages 15 to 25. This is likely due to the higher rates of participation in sports, accidents, and risk-taking among this age group.

Those most at risk for a brachial plexus birth injury include:

Brachial plexus injuries occur in about 1 to 3 births per 1,000. Approximately 20% to 30% of those injuries involve all five nerves.

Avulsion is the least common type of brachial plexus injury during childbirth, accounting for about 10% to 20% of cases.

Symptoms of a brachial plexus injury include:

Symptoms of a brachial plexus injury in newborns include:

Brachial plexus injuries in newborns usually dont cause much pain.

Most doctors are able to diagnose a brachial plexus injury. For treatment, youll usually need an orthopedist, orthopedic surgeon, or neurosurgeon. If you need a referral, your primary care doctor can make one for you.

In addition to taking a medical history, a doctor may perform or order the following to diagnose a brachial plexus injury:

Minor brachial plexus injuries may heal on their own, although this can take months. Nerves regenerate at a rate of about 1 inch per month.

Babies with brachial plexus injuries and adults with neuropraxia are more likely to heal on their own.

If a doctor thinks your injury might heal on its own, they may monitor you for a few months. They may also recommend nonsurgical treatments, such as:

If you dont start to improve during that time, they may move forward with surgery.

Some brachial plexus injuries require timely surgical treatment to prevent permanent loss of function. This is especially true of avulsions and ruptures. Surgery should take place within 3 to 6 months.

Depending on the type of brachial plexus injury, a doctor may recommend a specific surgery:

Surgeries for brachial plexus injuries typically involve an incision above your collarbone. There may be a second incision at the front of your shoulder.

Youll likely need physical therapy for several months after surgery.

Talk with a doctor to see if youre a candidate for surgery.

Recovery from a brachial plexus injury can take a long time. Minor injuries can take weeks or months to heal on their own. Even with surgery, you may not see results for at least a few months.

Occupational and physical therapy after surgery or even if your injury is healing on its own can help you regain strength and function. Depending on what level of motor function you have and how much youve lost, you may do exercises to build back your muscle strength and increase mobility or practice daily tasks such as writing.

As you recover, you should continue to see a doctor so they can check your progress. They can also help you manage pain with medication, therapy, and splints.

Without proper treatment, a brachial plexus injury can cause lasting damage. You may not ever have full use of your arm or hand, or you may have chronic pain. If you dont regain feeling in your arm or hand, it can lead to other injuries. For example, you may not recognize if youre holding something hot enough to burn you.

Depending on which nerves are damaged, you or your child may experience a related condition. These include:

Erbs palsy, also known as brachial plexus birth palsy, occurs when the upper branches of the brachial plexus are damaged during childbirth. Its one of the most common neurological birth injuries. Its usually due to traction of the babys neck during childbirth.

Its rare for Erbs palsy to result in permanent disability. About 10% to 30% of infants have permanent issues due to the condition.

Klumpkes palsy occurs when the lower branches of the brachial plexus are damaged. Its not common in newborns because its usually due to upward force on the arm or shoulder. It can affect the function of your hand and wrist.

Complete or pan-plexus palsy is damage in all five brachial plexus nerves. This will affect your entire arm. It will be limp and without sensation.

A brachial plexus injury can also lead to Horners syndrome. Thats when theres damage to the nerves in your sympathetic nervous system. Horners syndrome can cause:

Horners syndrome is usually a sign of a more serious brachial plexus injury.

The best way to prevent a brachial plexus injury is to keep yourself safe from injuries or events that can cause a brachial plexus injury. For example:

Brachial plexus injuries are usually the result of trauma, including falls, wounds, or car crashes. While this can be a very serious injury, its treatable. Many people will need surgery to heal their brachial plexus injury.

Brachial plexus injuries can also affect newborns during childbirth. These injuries usually heal on their own, but more severe cases may require surgery.

If you or your child have a brachial plexus injury, dont be discouraged if it heals slowly. This is typical. With proper treatment, whether nonsurgical or surgical, you should regain function and mobility.

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Brachial Plexus Injury: Types, Signs, and Treatment - Healthline