The brain sends and receives messages from the body through the nervous system. The nervous system is made up of the brain, spinal cord, and nerves. Nerves are the body’s “telephone wiring” system that carries messages between the brain and the rest of the body. Some nerves carry messages from the brain to muscles to make the body move, while other nerves carry messages about pain, pressure, or temperature from the body to the brain. There are also nerves that carry multiple kinds of information through different small fibers within the nerve. These small fibers can also cross between nerves, creating a network of connected nerves called a plexus.
The brachial plexus is a group of nerves that start at the spinal cord in the neck and travel down the arm (Figure 1). These nerves control the muscles of the shoulder, elbow, wrist, hand and fingers. The nerves of the brachial plexus also carry information about pain, pressure, and temperature from the fingers, hand, elbow, arm and shoulder to the brain. When the brachial plexus is injured, any or all of these important functions can be affected.
There are many ways the brachial plexus can be injured. An injury can occur from the nerves being stretched, having pressure applied to the nerve, or a sharp injury causing a direct cut to the nerve.
Stretching can occur when the head and neck are forced away from the shoulder, such as during a motorcycle or car accident. In newborn babies, stretching can also occur during vaginal delivery if the shoulder gets stuck as the baby is being pushed out. Stretching can happen along a nerve, causing it to swell or bruise. If the stretch is severe enough, it can tear a nerve completely or cause the nerves to tear out of their connection to the spinal cord.
Pressure can be caused by an injury to the anatomy around the brachial plexus, such as a fracture of the first rib or a shoulder dislocation. Swelling from bleeding or bruising of the surrounding area, or a tumor growing near the brachial plexus, can also cause pressure on the nerves.
The brachial plexus can also be directly cut with a traumatic injury from a sharp object or a forceful object like a bullet. It is also possible that a nerve in the brachial plexus could accidentally be cut during another surgery in the neck, shoulder, or arm.
Brachial plexus injuries are nerve injuries. The signs and symptoms of brachial plexus injury will be different depending on what nerve is injured, the type of injury, and the severity of the injury. Signs and symptoms may include:
Treatment of a brachial plexus injury will be different depending on what nerve is injured, the type of injury, and the severity of the injury. The most important first step in treatment is evaluation by a doctor who has experience treating brachial plexus injuries. They can determine the type and severity of the injury and make appropriate recommendations for treatment.
Types of treatment for brachial plexus injuries include:
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