The brachial plexus is a network of nerves that runs from your spine through your shoulder and down into your arm, controlling movement and sensation. Damage to these nerves can significantly affect movement and sensation, often impacting your ability to carry out everyday tasks.
What Causes Brachial Plexus Injuries?
Brachial plexus injuries occur when the nerves connecting the spine to the shoulder, arm, and hand are stretched, compressed, or torn. This can happen suddenly or develop gradually over time.
Birth trauma: Difficult deliveries, especially when the baby’s shoulder becomes lodged during birth (shoulder dystocia), can stretch or tear the brachial plexus.
Accidents and sports injuries: High-impact events, such as motorcycle crashes, falls, or contact sports collisions, can forcefully stretch the shoulder away from the neck, injuring the nerves.
Tumours or cancer treatment: Growths in the chest or underarm area can press on the nerves. Radiation therapy may also cause scarring that affects nerve function.
Inflammatory conditions: Rare conditions like Parsonage-Turner syndrome can cause sudden inflammation of the brachial plexus, leading to sharp pain followed by muscle weakness.
Symptoms of Brachial Plexus Injury
Symptoms can vary depending on which nerves are involved and how severely they are damaged. Some may appear immediately after an injury, while others develop gradually over time.
Loss of sensation: You may feel numbness or tingling in the shoulder, arm, or hand, often described as a persistent “pins and needles” sensation.
Severe burning pain: Some people experience sharp, shooting pain from the neck down the arm. This pain may worsen at night or with specific movements.
Muscle weakness: It may become difficult to lift your arm, grip objects, or perform tasks that require fine motor control, such as buttoning a shirt.
Muscle wasting: If the injury affects nerve signals for an extended period, the muscles in the shoulder, upper arm, or hand may shrink and become visibly weaker.
Brachial Plexus Injury Treatment
Treatment plan will depend on the type of injury, how long symptoms have been present, and the extent of nerve damage seen on clinical and imaging assessment.
Physiotherapy and rehabilitation: Targeted exercises help maintain joint flexibility and strengthen unaffected muscles. Occupational therapy can assist with adapting everyday tasks.
Nerve transfer surgery: Healthy nerves from nearby areas may be redirected to restore movement in weakened muscles. This is often time-sensitive and most effective when performed early.
Nerve grafting procedures: In cases where nerves are completely torn, nerve tissue from another part of the body may be used to reconnect damaged sections.
Pain management techniques: Chronic pain can be managed using a combination of medication, nerve blocks, or advanced techniques such as spinal cord stimulation.
Activities to Avoid During Recovery
Avoiding certain activities can help protect the affected nerves and support healing.
Heavy lifting or overhead movements: Refrain from carrying heavy items, lifting children, or reaching for high places unless advised by your specialist.
Contact sports: Sports involving collisions or falls can increase the risk of re-injury and should be avoided during recovery.
Prolonged immobilisation: Keeping the arm completely still for too long can cause joint stiffness. Gentle movement as recommended by your care team is important.
Unnoticed injuries due to reduced sensation: If you have numbness, you may not notice injuries like cuts, burns, or pressure sores. Regular checks are important to prevent unnoticed damage.
When to See a Hand Specialist
You should see a hand specialist if you experience:
- Persistent weakness or numbness in your shoulder, arm, or hand
- Difficulty lifting your arm or performing basic movements after an injury
- Burning or shooting pain radiating from the neck to the arm
- Muscle wasting or visible thinning in the upper limb
- No improvement in symptoms after a few weeks of conservative care
Conclusion
Recovery from a brachial plexus injury can vary. While some individuals regain strength and mobility, others may require long-term support and rehabilitation. Early diagnosis and timely treatment play an important role in improving outcomes.
If you are experiencing persistent arm weakness, numbness, or pain after an injury, schedule a consultation with our hand specialist in Singapore for a thorough evaluation and personalised care.
