Significance

• A brachial plexus injury involves damage to nerves that run from the spine to the hand, arm and shoulder. The occurs when the nerves are stretched or torn, most likely resulting from a forceful action to the shoulder where the head pushes in the opposite direction.
  
  

Symptoms

• The brachial plexus is a common injury in sports. A minor injury has the symptoms of an electric shock or the sensation of burning in the shoulder and down the arm. The pain and symptoms may shoot down the arm suddenly. The arm will then feel numb and have weakness. A severe injury to the brachial plexus has the symptoms of severe pain in the shoulder and arm with no control of the shoulder and elbow area. The fingers do not feel any pain and work normally.
  
  

Causes

• A minor injury occurs when the brachial plexus nerves are stretched. Football and wrestling sports are known for this injury and is referred to as a burner or stinger. A severe injury involves a tear or rupture in the nerve, usually separating at the point of the spinal cord.
  
  

Diagnosis

• Since nerves are involved in the injury, there are several tests that may be conducted to diagnose the problem. Electromyography involves inserting needle electrodes in the area to test nerve health. An alternate nerve study may be conducted by applying skin patches that emit electrical pulses to test the nerve. An MRI gives images of the soft tissue in the body and detects damage at the point of the spinal cord to see if the nerves have been torn. If the MRI does not give enough detail or information of the damage, a CT scan will be conducted. A CT scan involves injecting dye into spinal cord followed by a series of cross-section X-rays of the area.
  
  

Treatment

• Nerves that are stretched will many times repair themselves. In some cases, scar tissue will form during healing and must be removed surgically to allow the nerves to operate properly. Torn nerves require surgery to reattach the nerve. A nerve graft involves removing damaged area followed by attaching a nerve section from another part of the body to reattach the torn nerve to the spine. In some cases, a nerve transfer must be done which involves attaching the damage nerve to a less important nerve that is still attached to the spine. Recovery from nerve surgery may take up to 1 year as nerves grow slowly. For best results, surgery should be done within 3 to 6 months following the injury.