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Brachial Plexus Injury

The brachial plexus is a series of nerves/wiring that runs from your neck to the ends of your fingers. They start coming out from your cervical spine, spin and twist and intertwine, and then become the nerves in your arm. They send all the sensory information, such as touch, heat, vibration, and pain, from your arm to your brain, and they also have wires that go from your brain to your muscles to allow you to move your arm correctly.

Unfortunately, these nerves can be stretched, torn, or entirely ruptured in forceful injuries to our neck, arm or shoulder. The injury can cause a confusing pattern of pain, numbness, pins and needles and/or weakness – while many tests and investigations may appear somewhat normal.

Brachial plexus injuries

These injuries are also not very common, so it can take quite some time to get a diagnosis, as many health practitioners do not see them regularly. The injuries can be quite variable and can be confused for muscle tears, bursitis, neck problems etc. At times the diagnosis can become easier with time as symptoms become clearer – adding to the delay in diagnosis.

A brachial nerve injury diagnosis is not as simple as having a blood test that says, ‘yes,you have it’ or ‘no, you don’t'. It requires a detailed examination and investigations, possibly including an MRI and a nerve conduction study. And sometimes, even after these tests, the diagnosis can still be unclear.

When a nerve is stretched, we cannot always see that damage/injury on the scan. In the same way, your electrical cable for the kettle may ‘look’ normal, but if it has been stretched or heated, it may no longer conduct electricity, and the kettle may not work correctly. If I took a photo of your cable - I would say, ‘it looks fine’. But internally, it may be damaged and not work.

Your nerves are the same. They can look normal on a scan, but internally may not be working. The other test we may arrange is called a nerve conduction study. We put a tiny bit ofelectricity on one end of the nerve and then check the other end to see if there is a break or slowing of the electricity between those two points.

Brachial plexus coming from the cervical spine

The management of brachial plexus injuries requires what we call a multidisciplinary approach. We need the help of physiotherapists, occupational therapists, psychologists and specialists such as your pain physician, neurologist, surgeons and/or rehabilitation physician.

In many cases, brachial plexus injuries can heal and recover, but unfortunately, some injuries may never completely resolve. But we must do everything possible to maximise our body and mind’s healing ability.

At Resolve Pain, we are specialists in coordinating this care to minimise your pain and maximise your recovery. We may use exercise therapy to help with your strength, medications, and procedures to dampen your pain and aid recovery while trying to keep your life settled, such as addressing anxiety, depression and frustration regarding your injury with our psychologists and occupational therapists.

We have a Pain Program at Buderim Private Hospital that can offer the majority of these services working together to support recovery as much as possible.

Please discuss this with your Resolve Pain health practitioner if you would like more information.

There are links below for further information if you want to know more.

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