What is the Brachial Plexus and How Can it be Injured?
Friday, 21 May 2021

If you want to know what the brachial plexus is, how it can be injured, the potential symptoms of a brachial plexus injury and more, read on…

The brachial plexus is a network of nerves contained in the shoulder, which carry movement and sensory signals from the spinal cord to the arms and hands. Given how important the brachial plexus is, an injury can potentially lead to permanent disability in the worst case scenarios.

The causes of brachial plexus injuries are varied, and aren’t exclusively related to impact injuries in adults. In fact, they can also be the root of a birth injury compensation claim.

In this post, we’ll be taking a deep dive into brachial plexus injuries, how why they can occur, what the potential symptoms are, how they can be treated, and more. Take a look…

What is the Brachial Plexus?

 
As we’ve just touched on, the brachial plexus is a network of nerves in the shoulder. The nerves stem from root nerves in the neck and torso sections of the spinal cord, creating a network that connects the nerves to the arm.
 
The nerves control the motions in your wrists, hands and arms. They allow you to perform a wide range of functions, from raising and lowering your arm, to picking up and throwing objects, and typing on a keyboard.
 
The brachial plexus nerves also extend to the skin and are sensory. They help you to recognise if you’re picking up something that’s too hot or too cold.
 

What is a Brachial Plexus Injury?

 
The brachial plexus can be injured in a number of different ways. It will usually become damaged when the nerves are stretched, compressed or torn away from the spinal cord.
 
Brachial plexus injuries cut off all or parts of the communication between the spinal cord and the arm, wrist and hand. This means that someone can lose sensation or control over their arm or arms.
 

How Can the Brachial Plexus Be Injured?

 
Brachial plexus injuries tend to occur when the shoulder is quickly and suddenly forced down while the neck stretches up and away from the injured shoulder.
 

Brachial Plexus Injury in Adults

 
In adults, this sort of injury is likely to occur in:
  • Contact sports: for example, rugby or football players who collide with others or the ground may see their brachial plexus stretched beyond its limit.
  • Trauma: a traffic collision, fall from height, or any other sudden trauma.
  • Tumours and cancer treatment: it has been found that tumours can grow in or along the brachial plexus, or put pressure on the brachial plexus and spread to the nerves. Radiation treatment to the chest can also put pressure on the brachial plexus.
 

Brachial Plexus Injury in Babies

 
Injuries to the brachial plexus can also occur in babies during childbirth. The Brachial Plexus is particularly vulnerable during birth, which results in fairly frequent injuries. Previous research has indicated that injury to the brachial plexus occurs in one to two births per 1000.
 
Large babies are likely to be at increased risk of suffering a brachial plexus injury, as well as those which are born in the breech position. These types of injuries in babies tends to take one of two forms:
 
  • Erb’s palsy: numbness and loss of motion around the shoulder, leading to an inability to flex the elbow and lift the arm.
  • Klumpke’s palsy: a loss of motion or sensation in the wrist and hand.

 

What Different Types of Brachial Plexus Injuries Are There?

Brachial Plexus Neuropraxia

This is where the nerves are stretched to the point of injury. This occurs either through compression or traction. These injuries are often referred to as ‘burners’ or ‘stingers’, which is reference to the sensation someone experiences.

Brachial Plexus Rupture

A brachial plexus rupture occurs when a stretch causes the nerves to tear partially or completely. Ruptures are associated with much more severe pain and cause significant weakness in the shoulder, arm or hand.

Brachial Plexus Neuroma

When nerve tissue is damaged, such as from a cut during surgery, scar tissue can form as the nerve attempts to heal itself. This is called neuroma and can result in a painful knot in the brachial plexus nerves.

Brachial Plexus Avulsion

A brachial plexus avulsion occurs when the nerve completely separates from the spinal cord. This is the most serious brachial plexus injury, as it is often impossible to reattach the root of the spinal cord, leading to permanent weakness and paralysis.
 

How is a Brachial Plexus Injury Treated?

 
There are a range of different treatment options for a brachial plexus injury, depending on the severity and the length of time since it initially occurred.
 
Brachial Plexus Neuropraxia can be recovered without any further treatment, but a doctor may recommend rounds of physical therapy. This is designed to improve the range of motion and strength in the shoulder and arm.
 
For more serious injuries, like ruptures and avulsions, surgery may be required. There are various different types of surgeries that may be used, depending on the injury:
  • Neurolysis: frees up the nerve from scar tissue.
  • Nerve graft: the damaged brachial plexus is removed and replaced with sections of nerves from other parts of the body.
  • Nerve transfer: a bypass for nerve growth is achieved by taking a nerve that’s working, but less important, connecting to a nerve that’s not working but is important.
  • Muscle transfer: a surgeon removes a less important muscle or tendon (typically the thigh) and transfers it to the arm.

 

Do You Need to Know Anything More About Brachial Plexus injuries?

 
So, what have we learned? In this post, we’ve explained what the brachial plexus is, how it can be injured, the types of injuries someone can suffer and how they might be treated.
 
Have you previously injured your brachial plexus? Or are you concerned that you’ve suffered a brachial plexus injury and you aren’t sure what you need to do next? Feel free to leave a comment below describing your experiences.
 
Please be advised that this article is for general informational purposes only, and should not be used as a substitute for advice from a trained medical professional. Be sure to consult a medical professional or healthcare provider if you’re seeking medical advice, diagnoses, or treatment. We are not liable for risks or issues associated with using or acting upon the information on this site.
 

Photo Credits:

 
Photo 1 – Camilo Jimenez via Unsplash
Photo 2 – Christian Bowen via Unsplash
Photo 3 – Anna Shvets via Pexels
 
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