Brachial Plexus

What Is Brachial Plexus?

Brachial PlexusBrachial Plexus

If you have damage to the brachial plexus, you can experience problems, such as pain or weakness in the shoulder, elbow, wrist, or hands. If severe enough, you may not be able to use your arm. 

At the Yale Hand and Microsurgery Program, we use advanced microsurgical techniques to repair damaged muscles and tendons and the delicate nerves of the brachial plexus. Our team of hand surgeons, neurosurgeons, neurologists, and clinical specialists work to restore function of your arm and to reduce pain, weakness, and other symptoms of brachial plexus nerve injury.

An overview of the brachial plexus anatomy may help you understand your condition better, and how an injury to your neck region can affect your arms and even your hands. 

The brachial plexus is a nerve bundle that begins in the spine in the neck region. This region of the spine is called the cervical spine and is made of seven vertebrae. Each vertebra is abbreviated according to its numerical order in the cervical spine. The abbreviations are C1 through C8. So, the first vertebra in the cervical spine, which is the vertebra closest to the skull, is called C1 and the second is C2, and so forth. 

The brachial plexus begins at C5 and travels through the rest of the neck vertebra (C6 through C8). It then proceeds through the first vertebra (T1) in the thoracic region, or rib cage region, then moves under the collar bone, through the underarm, and into the arm.

The brachial plexus nerves extend to the triceps, wrist extensors, and hands, which is why, for example, an injury to your cervical vertebra can affect your hands. 


    Causes of Brachial Plexus

    At the Yale Hand and Microsurgery Program, we understand that the symptoms of brachial plexus nerve damage can be frustrating, especially if the cause is unknown. 

    In most cases, however, damage to this intricate and delicate nerve structure is caused by pressure, stretching, or cutting in the neck area.  

    Common reasons of damage to the brachial plexus include: 

    • Traumatic injury, such as a high-velocity motor vehicle accident 
    • Birth if the baby’s neck or shoulder was abnormally stretched during delivery
    • Pressure from tumors in the area
    • Radiation therapy 
    • Exposure to toxins, chemicals, or drugs
    • Inflammatory conditions, such as those due to a virus or immune system disorder

    If you have sustained damage to the brachial plexus nerves, the signal that the nerve carries to the brain can stop. Without nerve impulses, the muscles in your arm and hand may not work properly, or you may have loss of feeling in your hand and wrist. 

      Symptoms of Brachial Plexus

      If you have sustained damage to the brachial plexus nerves, the signal that the nerve carries to the brain can stop. Without nerve impulses, the muscles in your arm and hand may not work properly, or you may have loss of feeling in your hand and wrist. 

      Symptoms you may experience are:

      • Weakness in the shoulder, elbow, wrist, or hand
      • Tingling, burning, pain, or abnormal sensations
      • Inability to move at any of these joints
      • Clawing of the hand or other abnormal position
      • Diminished reflexes in any part of the arm
      • Diminished sensation in any part of the arm

      We can diagnose if you have the condition during an exam of your arm, wrist, and hand. Some of the signs we will look for include:

      • Level of difficulty moving the shoulder, arm, hand, and fingers 
      • Arm reflexes 
      • Ability to flex your hand
      • Wasting of the muscles

      We might also use diagnostic tests. Some of these tests may include: 

      • Blood tests
      • Chest X-ray
      • Electromyogram (EMG)
      • MRI of the head, neck, and shoulder
      • Nerve conduction tests

      The type of treatment will depend on the severity and the cause of the damage, so discussing a detailed health history will help determine the cause of the brachial plexus nerve damage. 

      This list should be used as a guideline. Not every symptom is included. If you or a loved one has one or more of these symptoms, it does not mean that he or she has brachial plexus. If you are concerned that you or a loved one might have brachial plexus, please make an appointment with your doctor.

        Treatments for Brachial Plexus

        If you have injured the brachial plexus nerves, it is normal to fear that your damage may be permanent. You may also wonder if surgery will be necessary. 

        Some brachial plexus injuries are minor and will recover on their own completely in several weeks or months. However, if you have sustained severe injury to the nerve bundle, you may have permanent disability in the arm, hand, and wrist. Some factors that can affect recovery after brachial plexus injury include your age and the type, severity, and location of your injury.

        At the Yale Hand and Microsurgery Program, we create a treatment plan tailored for you depending on the extent of your injury; while creating the plan, we consider your occupation, preferred activities, and lifestyle. Our surgeons, J. Grant Thomson, MD, FRCS, FACS, and Michael Matthew, MD, offer the latest techniques and specialized expertise to restore motor function and sensation through nerve and muscle transplantation from undamaged nerves and muscles in your body. 

        Dr. Thomson and Dr. Matthew specialize in brachial plexus injuries, reconstruction, repair, peripheral nerve surgery, occupational disorders of the upper extremity, and microsurgery.