The brachial plexus is a network of nerves that originate from the neck’s cervical vertebrae and run down both sides of the upper thoracic spinal column located in the chest. These nerves control the arms and hands.
Damage to the brachial plexus is typically a result of a motor vehicle accident, motorcycle accident or fall. In its more mild form, symptoms may include shoulder pain and numbness, and a burning/tingling sensation or weakness in the arm or hand. In more severe forms of brachial plexus injury, however, the entire arm may be non-functional. This type of injury most likely requires surgery for reconstruction of the elements of the plexus. Prognosis is variable according to the severity of the injury.
This condition results when a newborn’s brachial plexus is damaged during birth. Whether from a breech birth or the position of the baby’s shoulders in the birth canal, there can be a broad range of damage to the nerves, from relatively minor (the nerves are damaged, but not torn), to a complete tearing of the nerve from the spine.
Symptoms are noticed immediately or soon after birth, and may include impaired reflexes, abnormal positioning of the arm, decreased grip, and impaired spontaneous movement of the arm, hand or shoulder.
The vast majority of these babies will regain normal or near normal function of their arms via prescribed range-of-motion exercises. However, surgical intervention may be recommended if improvement isn’t detected by the time the baby is six to eight months old. When necessary, surgery may include using other nerves from other parts of the baby’s body to repair the damaged ones, or removing scar tissue from the nerves. If such early surgery isn’t successful, a tendon transfer may be recommended before the child reaches seven years of age.
Klumpke’s palsy, like Erb’s palsy, results from damage to the brachial plexus during a complicated birth, for instance, when the baby’s arm is pulled in an upward motion during delivery.
This specific damage causes paralysis of the muscles focused in the forearm and/or hand. Horner’s syndrome may also be present, which is a clinical syndrome that results in one side of the face drooping due to paralysis.
As with Erb’s palsy, prescribed exercises and surgery that targets the specifics of the brachial plexus damage are usually the recommended course of action in the baby’s early months.
Radiation-induced brachial plexopathy can arise as a complication from local radiation treatment (such as from lung or breast cancer treatment). Symptoms from this entity may include pain, numbness and/or weakness of the arms. Frequently, surgery can be offered to alleviate pain or improve function.
This syndrome occurs when a rib or a fibrous band of tissue compresses the brachial plexus. Patients most vulnerable to thoracic outlet syndrome are those who have received neck or thoracic injuries (such as those from car accidents), those who have anatomical abnormalities (such as an extra rib or an abnormally tight fibrous band connecting spine to ribs), and those who repetitively use certain postures that affect this area of the body (such as swimmers or people with jobs that require continuous heavy lifting).
The symptoms of thoracic outlet syndrome include pain, numbness, and/or tingling in the neck and shoulder, as well as weakness in the hands.
Improved posture and exercises to strengthen the neck and shoulders are beneficial to some patients and are usually the first line of defense. However, in other cases, surgery may be needed to remove parts of or the entire rib or tissue that is causing pressure on the brachial plexus.