Brachial Plexus Injury/Jill Pantano, DPT, OCS

Recently, I managed a patient with a brachial plexus injury as a result of a shoulder dislocation. While not terribly common in the clinic, it is a disabling injury that has sever ramifications.

The brachial plexus is a network of intertwined nerves that exit from the spinal cord in your neck and cross your chest to your armpit. They control the sensation and movement of your arm and hand. Injury occurs from forceful stretching of these nerves. This can occur from motor vehicle accident, fall, or any forceful pulling of the arm.

Injury to the brachial plexus can occur at different locations and usually dictates the severity of the injury. Injury closer to the spinal cord is more severe than injury further down the nerve. The injury can range from a mild stretch of the nerve [neuropraxia] to rupture where there can be partial or complete tearing of the nerve. Symptoms can be mild pain, numbness, and weakness but may vary to severe pain and loss of movement or paralysis.

Your physical therapist will be able to diagnose your injury and determine if any other associated injuries exist. The pattern in which nerves from the brachial plexus control various muscles in the arm and hand will help your physical therapist identify the site of the nerve injury to best treat it.

Timeframe is important for these injuries. The longer a muscle lacks input from the nerve the less likely function will return. Thus, it is important to address these issues as soon as possible. Not all brachial plexus injuries can be treated conservatively with physical therapy. Some may require surgery, especially if the nerve is fully torn.