Brachial Plexus Trauma: When Your Arm and Hand Stop Talking to Your Brain

Did you find this article by Googling “Why can’t I suddenly can’t move my arm”? Perhaps you had to type with one hand because the other feels numb and is acting funny. These could be signs of brachial plexus trauma.

Brachial plexus trauma is a nerve injury in the shoulder, arm, wrist, or hand. Damaged nerves can’t transmit instructions from the brain to tell an arm to swing or fingers to grip. If you have pain from a nerve injury, it might seem like your arm or hand forgot how to do simple jobs, like using a pen or a TV remote. It’s weird—and scary.

Brachial plexus disorders usually heal well if they’re not severe. According to Johns Hopkins Medicine, most people with minor brachial plexus injuries can regain 90%-100% of their normal arm function without surgery.

Keep reading to learn about brachial plexus injury symptoms, the latest treatment options, what to do if you experience brachial plexus trauma, and the curious “Rule of Seven 70s.”

What Is the Brachial Plexus?

Body parts move and feel when the brain tells them to. It seems automatic, but every motion and sensation relies on a complex bundle of nerves delivering those instructions. A nerve injury can interrupt such signals, resulting in lost motion and feeling.

The brachial plexus is a group of five nerves that run from the top of the spinal cord down the arm. There is one on each side of the body. The intricate system controls the shoulder, elbow, wrist, and hand. Each nerve is responsible for a different function. 

Trauma to the Brachial Plexus Nerves

Brachial plexus trauma refers to any damage to this network of nerves caused by inflammation, pinching, stretching, or cutting. The trauma may be classified as an avulsion, neuroma, rupture, or stretch, depending on its severity.

Avulsions

The most serious type of brachial plexus trauma is an avulsion. This is an injury when the nerve is severed at the root of the spinal cord. Its treatment usually requires surgery. 

Neuromas

When a brachial plexus nerve tries to heal itself, a neuroma—or clump of scar tissue—may form and cause pain. After a traumatic injury, nerve specialists may use a surgical approach to prevent or reduce the risk of neuroma formation and create a healthy environment for healing.

Ruptures

A rupture is a partial or complete tear of the brachial plexus nerve due to compression or excessive stretching. This type of trauma to the nerve can sometimes be repaired with surgery.

Stretches

A stretched brachial plexus nerve is considered a mild to severe pull. This condition, also called neuropraxia, may respond to rest and occupational therapy, but—if it results in the formation of a neuroma—healing may require surgery.

Causes of Brachial Plexus Trauma

It takes a forceful impact on the arm or neck to damage the brachial plexus nerves directly. This trauma is typically associated with nerve damage caused by gunshot wounds, vein or artery injuries, knife wounds, falls, surgical errors, athletic injuries (particularly with contact sports), and motorcycle or car wrecks.

The most frequently reported cause of traumatic brachial plexus injuries is motorcycle accidents. In fact, 70% of brachial plexus nerve damage is associated with road accidents, and 70% of those are from motorcycle crashes. These stats are part of the “Rule of Seven 70s,” or seven circumstances that occur 70% of the time in brachial plexus injuries. 

It’s also estimated that 70% of trauma to the brachial plexus occurs along with another condition or injury, such as an arm, rib, spine fracture, brain injury, collapsed lung (or bleeding in the lung or chest cavity), spinal cord injury, cancer, or radiation treatment.

Discuss your nerve pain symptoms with an expert

Symptoms of Brachial Plexus Trauma 

Depending on the location and the severity, a brachial plexus injury may produce these symptoms in arms and hands:

• Burning or stinging pain sensations,
• Numbness,
• Paralysis,
• Inability to perform routine tasks,
• Limp arm, and
• Drooping eyelid on the opposite side.

“Burners and Stingers”

Burners and stingers are bolts of pain associated with some brachial plexus injuries. While the loss of sensation is one symptom of brachial plexus trauma, a patient can also experience sporadic shots of intense pain that might feel like an electrical shock. 

Burners and stingers are associated with neuropraxia, which is a form of brachial plexus trauma. There are two causes of neuropraxia: compression and traction. Compression is a pinched nerve from over-rotating the head or neck and is more common in older adults. Traction is when the arm is yanked downward and is more common among adolescents and young adults. 

Diagnosing Traumatic Brachial Plexus Conditions

Trauma to the brachial can mimic the symptoms of other shoulder injuries, such as rotator cuff tears. However, brachial plexus trauma is less likely than other injuries to occur from repetitive motions and overuse. However, symptoms such as weakness, pain, and reduced mobility overlap with muscle and joint injuries. It’s essential to see a physician for an accurate diagnosis. 

Physicians begin diagnosing brachial plexus injuries by performing physical exams of the arm, shoulder, and hand to gauge strength and mobility. Imaging (e.g., X-rays, MRIs, CT scans) and nerve conduction tests may be necessary to look for fractures, electrical activity, and other damage or to confirm a diagnosis.

Learn more about how IHTSC’s physicians diagnose nerve pain

Treatment for Brachial Plexus Injuries

Depending on the severity, brachial plexus trauma may heal on its own in a few weeks to a few months. If not, treatment options abound.

Non-Invasive Nerve Care Options

Mild to moderate traumatic brachial plexus injuries may respond well to conservative treatments, such as:

• Rest,
• At-home exercises,
• Pain medication,
• Corticosteroid cream or injections for pain,
• Physical therapy to restore function, and
• Occupational therapy to learn to perform daily tasks safely while the nerve heals.

Learn more about treatments offered by IHTSC’s Nerve Injury & Limb Pain Program

Surgical Solutions

Nerves slowly heal and may not regenerate completely after a severe injury. Luckily, the body contains spare muscles, tendons, and nerves that can be moved to the brachial plexus or arm without compromising strength or movement elsewhere. These surgical procedures are the most advanced treatments for brachial plexus trauma:

• Nerve Grafts: Reconnecting the two ends of a severed nerve with a section of nerve from another part of the body.
• Nerve Transfers: Attaching a non-vital nerve from another area of the body to the damaged nerve to provide a structure for regrowth
• Muscle Transfers: Relocating a less-important muscle from another part of the body (often the inner thigh) to the arm to restore function. 
• Joint Fusions: Attaching bones to each other (usually in the shoulder, upper arm, or wrist) to provide stability when nerve restoration isn’t successful.
• Tendon Transfers: Relocating a less-important tendon elsewhere (usually the arm or shoulder) to the arm to restore function.

Get care from an IHTSC nerve pain relief specialist

FAQs About Types of Brachial Plexus Trauma

What Is Parsonage-Turner Syndrome?

Parsonage-Turner syndrome (also known as brachial neuritis, idiopathic brachial plexopathy, or neuralgic amyotrophy) is a rare neurological disorder involving the brachial plexus nerve that causes sudden pain. PTS can be challenging to diagnose since medical researchers have yet to identify a precise trigger for this uncommon condition, and its symptoms are sometimes mistaken for cervical radiculopathy.

Discover how IHTSC’s team helped a 27-year-old diagnosed with Parsonage-Turner syndrome

What Is Global Palsy?

Global palsy, or pan-plexus palsy, happens when all of the brachial plexus nerves are damaged. It’s sometimes called a “flail limb” because it completely paralyzes the whole arm, from the shoulder to the fingertips. 

What Is Erb’s Palsy?

Erb’s palsy is a brachial plexus injury that affects babies. The upper arm nerve damage occurs during childbirth and may result in loss of feeling, movement, or paralysis. The baby may be unable to flex the elbow, lift the arm, or raise objects to the mouth. Nearly all cases of obstetric brachial plexus injury cases are resolved within six months to a year. It’s possible, but rare, that Erb’s palsy causes lasting complications with development.

What Is Klumpke’s Palsy?

Also called Dejerine-Klumpke palsy, this kind of brachial plexus trauma affects the lower arm. It often occurs during childbirth but can develop later in life from an injury. Klumpke’s palsy is associated with “claw hand,” a deformity caused by weakness or paralysis of the hand and wrist.

What Is Upper-Trunk Palsy?

Upper-trunk palsy is a condition that’s caused when the angle between your shoulder and neck is widened forcibly, such as after a traumatic fall. Symptoms include losing strength or sensation in the affected arm, difficulty moving that arm and shoulder, and painful tingling. Treatment options include physical therapy and surgery. 

Specialized Care for Traumatic Brachial Plexus Injuries

Nerves are sensitive, slow-healing, and essential for a full quality of life. Without proper medical attention, a brachial plexus trauma can easily cause long-lasting pain or function loss and result in collateral damage to other parts of the body when you compensate for the injury. For instance, if your hands have lost some feeling, you risk dropping objects or suffering burns or cuts while cooking.

Schedule an appointment with a specialist in treating nerve conditions if you’re experiencing any signs of brachial plexus trauma. Early detection can prevent further damage and pain, help you avoid surgery, and give you the best chance for regaining full function promptly.

Why Choose IHTSC’s Nerve Clinic for Care

For over 50 years, the world-class specialists at Indiana Hand to Shoulder Center have been successfully diagnosing and treating people with pain caused by brachial plexus trauma. 

At the IHTSC Nerve Clinic, we offer team-based care. This collaborative approach allows us to combine our collective knowledge and expertise to generate an ideal treatment plan for patients with complex nerve injuries.

Our services include advanced diagnostics, in-house therapy, and surgical solutions using the latest techniques. If you need a complex procedure like a nerve transfer procedure, you will be in the best hands with IHTSC’s renowned nerve pain surgeons.

If you are experiencing any symptoms associated with brachial plexus nerve injuries, we can help. Contact us for a consultation right away. Call (317) 743-3985 or schedule an appointment online.

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You Might Also Like:

• What to Know About Brachial Plexus Injury and Fixing Damaged Nerves
• Managing and Treating Phantom Nerve Pain After Limb Amputation
• Why Does My Arm Hurt? How Can I Get Arm Nerve Pain Relief?

Medically reviewed by Kathryn Peck, MD