What is a brachial plexus injury?

Brachial plexus injuries are caused by excessive stretching, tearing, or other trauma to a network of nerves from the spine to the shoulder, arm, and hand.

Symptoms may include a limp or paralyzed arm, loss of muscle control in the shoulder, arm, hand, or wrist, and lack of feeling or sensation in the arm or hand.

Injuries often occur secondary to vehicular accidents, sports injuries, gunshot wounds, or surgeries. Many brachial plexus injuries happen during birth, if the baby’s shoulders become impacted during the birth process (called shoulder dystocia), causing the brachial plexus nerves to stretch or tear.

Some brachial plexus injuries may heal with little or no treatment. Many children improve or recover by 3-4 months of age. To expand range of motion and speed rehabilitation, physical and occupational therapies are usually employed. However, some who appear to be recovered will have secondary issues months or years later.

Treatment

Treatment for brachial plexus injuries includes occupational or physical therapy and, in some cases, surgery. The site and type of brachial plexus injury determine the prognosis.

For avulsion (tears) and rupture injuries there is no potential for recovery unless surgical reconnection is made in a timely manner.

For neuroma (scarring) and neuropraxia (stretching) injuries the potential for recovery is more encouraging. Most patients with neuropraxia injuries recover a significant amount of function.

The major area of concern to most people with brachial plexus injuries is often management of pain, which can be chronic and extreme, and which does not generally respond well to many painkillers.

Those with a birth related brachial plexus injury vary widely regarding pain. Some experience no pain, as their sensation is diminished; others are hypersensitive to pain as well as to any stimulus.

Some may eventually experience pain on the unaffected side because they chronically overuse their uninjured arm for everyday activities.

According to the United Brachial Plexus Network, obstetrical injuries of this sort are not reported to the Centers for Disease Control; therefore, many cases are incorrectly diagnosed or referred to as Erb's Palsy.

Resources

If you are looking for more information on brachial plexus injuries or have a specific question, our information specialists are available business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9am to 5pm ET.

Additionally, the Reeve Foundation maintains a brachial plexus injury fact sheet with additional resources from trusted Reeve Foundation sources. Check out our repository of fact sheets on hundreds of topics ranging from state resources to secondary complications of paralysis.

We encourage you to reach out to support groups and organizations, including:

Sources: United Brachial Plexus Network, Brachial Plexus Palsy Foundation, National Institute of Neurological Disorders and Stroke.

This project was supported, in part by grant number 90PR3002, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.