Brachial Plexus Injury

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is brachial plexus injury?

Brachial plexus injury refers to any damage to the brachial plexus, a set of nerves that runs between your spine and your shoulders, arms and hands. Damage to these nerves can result in abnormal sensations, numbness, tingling, or difficulty controlling the muscles of the shoulder, arm or hand.

Injury to the brachial plexus can be very mild, such as in the case of a stretch or compression injury (athletic stinger). It can also be quite severe if nerves in the brachial plexus become crushed or severed. Brachial plexus injury can occur as a result of trauma, masses or swelling (including tumors), surgery, or inflammation, including inflammation due to infection.

Brachial plexus injury can be permanent, as in the case of a completely severed nerve, or it may spontaneously resolve, as with in certain cases of inflammation. Physical therapy may help you regain normal feeling and arm function in some cases of brachial plexus injury. Severe cases of brachial plexus injury may require surgery. The effectiveness of treatment depends on the severity and location of the brachial plexus injury.

Weakness, numbness or tingling in the arm can in some cases be a sign of stroke. Seek immediate medical care (call 911) for sudden, severe pain in the arm or inability to move the arm, accompanied by sudden weakness or paralysis on one side of your body; a change in level of consciousness, such as passing out or unresponsiveness; sudden, severe headache; or difficulty with speech or vision.

Seek prompt medical care if you experience mild but persistent symptoms of brachial plexus injury, such as pain, swelling, numbness, or a lack of muscle control in the arm, hand or wrist.

What are the symptoms of brachial plexus injury?

Symptoms of brachial plexus injury include problems with sensation and a lack of muscle control in the hand, arm and shoulder area. Generally, symptoms include pain, numbness, and difficulty moving.

Common symptoms of brachial plexus injury

Common symptoms of brachial plexus injury occur in the shoulder, arm or hand. You may experience brachial plexus injury symptoms daily or just once in a while. At times any of these symptoms can be severe:

  • Loss of sensation

  • Muscle weakness

  • Numbness or tingling

  • Redness, warmth or swelling

  • Reduction in limb flexibility

  • Shoulder, arm, hand or finger pain

  • Soreness

  • Tingling or other unusual sensations in the shoulder, arm or hand

Symptoms that might indicate a serious condition

In some cases, weakness, numbness or tingling of the arm of hand can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care if you, or someone you are with, have any of these serious symptoms including:

  • Change in level of consciousness, such as passing out or unresponsiveness

  • Garbled or slurred speech or inability to speak

  • Paralysis of the shoulder, arm or hand

  • Shoulder, arm, hand or finger pain that is sudden and severe

  • Sudden change in vision or loss of vision

  • Sudden severe headache

  • Sudden weakness, numbness, or tingling on one side of the body

What causes brachial plexus injury?

Brachial plexus injury can arise when the nerves of the brachial plexus are compressed, stretched or cut. Compression of the brachial plexus nerves may occur due to inflammation or a tumor pressing on the nerve. Stretching may occur as the result of the shoulder’s being forced apart from the head and neck. In more severe cases, nerves may become severed from the spinal cord, generally as a result of a serious injury or surgery.

Common causes of brachial plexus injury

Often, brachial plexus injury is mild, and may be caused by:

  • Brachial plexitis (inflammation of the brachial plexus for unknown cause)

  • Cyst (benign sac that contains fluid, air, or other materials)

  • Damage to the brachial plexus during birth

  • Infection in the shoulder, arm or hand

  • Inflammation in the shoulder, arm or hand

  • Nerve injury

  • Shoulder injury

Serious causes of brachial plexus injury

In serious cases of brachial plexus injury, the nerves may be cut from the spinal cord (a condition called avulsion) or become severely compressed. Causes of brachial plexus injury which may not resolve spontaneously include:

  • Autoimmune inflammatory disorder

  • Surgery

  • Traumatic injury

  • Tumor

What are the risk factors for brachial plexus injury?

A number of factors increase the risk of developing brachial plexus injury. Not all people with risk factors will get brachial plexus injury. Risk factors for brachial plexus injury include:

  • Birth (difficult deliveries pose an increased risk for the baby)

  • Family history of autoimmune inflammatory disorders

  • Infection affecting the shoulder or arm

  • Job that requires strenuous or repetitive use of the shoulders, arms and hands

  • Participation in extreme sports

  • Shoulder, arm or hand injury

  • Spinal surgery

  • Sports injuries

Reducing your risk of brachial plexus injury

You may be able to lower your risk of brachial plexus injury by:

  • Avoiding repetitive or strenuous use of the shoulders, arms and hands

  • Using appropriate protective gear when participating in sports

How is brachial plexus injury treated?

Mild brachial plexus injuries will often heal spontaneously. In cases in which the brachial plexus injury is related to another injury, inflammation or a growth, treatment of the underlying cause will often resolve the brachial plexus injury.

In serious cases of brachial plexus injury, surgery may be required to restore functionality. Physical therapy may also be helpful for restoring feeling and arm function. If the nerves of the brachial plexus are severed entirely, the damage may be permanent.

Surgical intervention for brachial plexus injury

In many cases of brachial plexus injury, surgery may be used to restore function. Surgical techniques to repair brachial plexus injury include:

  • Nerve repair

  • Nerve replacement (surgical transplant of nerves from another area of the body)

  • Surgery to remove a growth or tumor affecting the brachial plexus

Other treatments for brachial plexus injury

For mild cases of brachial plexus injury, nonsurgical techniques may be used including:

  • Anti-inflammatory drugs

  • Pain medications

  • Physical therapy

  • Treatment of the underlying infection

What you can do to improve your brachial plexus injury

Recovery from a brachial plexus injury requires that you maintain flexibility of the shoulder, arm and hand. Pain management, and management of swelling and inflammation, may also assist you in recovering from brachial plexus injury. You may be able to improve your brachial plexus injury by:

  • Maintaining activity of the shoulder, arm and hand

  • Routinely stretching your shoulder, arm and hand

  • Taking over-the-counter pain medication

  • Using hot or cold compresses

Complementary treatments

Some complementary treatments may help some people in their efforts to deal with brachial plexus injury. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture

  • Massage therapy

  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

  • Yoga

What are the potential complications of brachial plexus injury?

Generally, brachial plexus injury will resolve either spontaneously or with treatment. In some cases, however, such as when a nerve has been completely severed or when the injury is due to a serious infection or tumor, there may be long-term complications. Complications of untreated brachial plexus injury can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of brachial plexus injury include:

  • Limb disfigurement

  • Paralysis

  • Permanent disability

  • Permanent loss of sensation

  • Severe discomfort or pain

  • Spread of cancer

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. NINDS brachial plexus injuries information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/brachial_plexus/brachial_plexus.htm.
  2. Brachial plexus. American Society for Surgery of the Hand. http://www.assh.org/Public/HandConditions/Pages/BrachialPlexus.aspx.