The brachial plexus is the network of vital nerves that connect the spinal cord to the nerves in the shoulders, arms and the hands. An injury to the brachial plexus region may result in these nerves getting stretched, compressed and even ripped apart from the spinal cord itself in more severe injuries.
A minor injury (called a stinger/burner) is commonly seen in contact sports (such as football, soccer, etc) and in babies during the birth process. Inflammation, tumors, etc can also cause brachial plexus injury.
The more severe forms of brachial plexus injuries are seen as a result of automobile/motorcycle accidents which may cause paralysis in the arm.
Surgical treatments such as nerve transfers, nerve grafts and muscle transfers are required in such severe cases of brachial plexus injury.
What are the Signs And Symptoms of Brachial Plexus Injury?
The signs and symptoms of any two brachial plexus injuries can vary greatly as they mostly depend on the location and severity of the injury. Usually only one side of the body (shoulder/arm) is affected.
These are the commonly seen symptoms after a minor brachial plexus injury (known as stingers/burners):
- Electric shock/burning like sensation down the arm
- Numbness/weakness in the arm
These symptoms are infrequent and may last for several seconds or few minutes although in rare cases these symptoms may also last for days or even longer than that.
These are the more commonly seen symptoms in case of a severe brachial plexus injury:
- Weakness/inability using certain shoulder, arm or hand muscles
- Complete paralysis/loss of sensation or movement in the affected arm, shoulder and hand
- Severe/disabling pain
It is advisable to consult an experienced doctor or a neurologist if the patient has:
- Recurring burners/stingers
- Weakness in hand/arm
- Weakness in arm after an injury
- Pain in the neck
- Complete upper extremity (arms and hand) paralysis after an injury
- Both arms display symptoms
- Symptoms are seen in upper and lower limbs
What are the Causes of Brachial Plexus Injury?
Brachial plexus damage is sustained when the upper nerves in it tend to be forced down by the shoulder while the rest of the nerves in the neck are stretched away from the injured shoulder. The lower nerves are likely to be injured when the arm is twisted away and above the head. These injuries can occur due to:
- Contact Sports – Football or soccer players are more prone to burners/stingers mainly due to the collision in these sports that tend to stretch the brachial plexus nerves.
- Birth Difficulties – Newborns can sustain severe injury to the nerves in the brachial plexus if there are complications during birth (breech position, prolonged labor, etc) when an infant’s shoulder gets wedged inside the birth canal. Erb’s palsy is denoted when the infant’s upper nerves are injured during the birth process. Total brachial plexus injury occurs when the upper and lower nerves get damaged.
- Trauma – Severe trauma sustained due to an automobile accident, fall, bullet wound or other similar instances can also result in brachial plexus injury.
- Inflammation – The rare condition known as Parsonage-Turner Syndrome (brachial plexitis) may also result in brachial plexus injury and cause paralysis of certain muscles in the arm.
- Tumors – Benign (non-cancerous) tumors (or even cancerous tumors) can grow in the brachial plexus region and put pressure on it. This affect can spread to the nerves and cause damage to the brachial plexus.
- Radiotherapy – Radiation therapy may also cause brachial plexus injury.
The complications resulting from brachial plexus injury include:
- Rigid joints – In case paralysis of the arm or hand is felt then the joints in the arm tend to get stiff, which makes movement difficult, even after restoring sensation in the arm. Effective physical therapy is required to treat such a complication.
- Pain – May become chronic (long-term) if left untreated as it is a result of nerve damage.
- Loss of sensation – Loss of feeling in the arms or hands can lead to other injuries such as burns, as the reflexes will not be responsive in it.
- Muscle Atrophy – The muscles may tend to get degenerated and weakened after a prolonged non-use.
How is Brachial Plexus Injury Diagnosed?
A brachial plexus injury may require one or more from the following diagnostic tests:
- EMG (electromyography) – This test requires inserting a needle with an electrode through the skin and into the different muscle groups to check for the level of electrical activity in the muscles. Mild discomfort might be felt as the needle is initially inserted.
- Nerve Conduction Studies – These are performed usually in combination with EMG to measure the speed of conduction in the nerves when it is stimulated by a small electric current. This gives an idea of the functioning of the nerve.
- MRI (magnetic resonance imaging) – This test uses magnetic fields and radio waves to create a detailed and cross-sectional 3-D view of the body in multiple levels.
- CT (computerized tomography) scan – This technique uses a series of x-rays to obtain a cross-sectional view of the body. Contrast material is often injected into the region before proceeding with a CT scan as this helps to create a better and more detailed image.
How is Brachial Plexus Injury Treated?
There are several treatment methods for treating brachial plexus injuries and the specific type of treatment or a particular case depends on various factors, such as the severity, type, period of time passed after the injury, etc as well as other existing medical conditions.
Nerves that are mildly stretched may often recover with rest and might not even need any form of treatment. This process may rarely result in scar tissue forming as the nerves heal and restrict the function of the affected region. Surgical removal of the scar can help to restore the restricted range of motion.
Surgery is mostly advised within 6-7 months from the date of injury to the brachial plexus as a period of more than 6-7 months may result in permanent damage to the nerves in the brachial plexus.
These are the different types of brachial plexus injury treatment surgeries:
- Nerve graft – This procedure requires harvesting a healthy nerve from another part of the body in order to remove and replace the damaged nerve. This helps to restore function in the arm.
- Nerve transfer – This surgery is required in severe cases of brachial plexus injuries that have resulted in the nerve being completely detached from the spinal cord. The surgeon will source a smaller nerve from another part of the body (still connected to the spinal cord) and use it to re-establish the connection between the detached nerve and the spinal cord.
- Muscle transfer – This procedure involves removing a less-important muscle/tendon from another part of the body and using it to reconnect the nerves and blood vessels supplying the affected arm.
Why Choose Travcure for Brachial Plexus Injury Treatment in India?
Travcure is known for providing the best and most effective medical tourism service in India. It is connected to the world’s largest healthcare network in India that covers all its major cities, such as Mumbai, Bangalore, Kolkata, etc for added convenience. Travcure offers every patient with the most effective, advanced and affordable brachial plexus injury treatment in India at the hands of the most experienced and well-trained neurologists and specialists.