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Physical Therapy for Brachial Plexus Injuries

The brachial plexus is a group of nerves that sends signals from the spine to your arm, hands, fingers. Brachial plexus injuries are caused by damage to some of this network of nerves. There are different types of brachial plexus injuries.
Physical therapists, are professionals who diagnose and treat those with brachial plexus injuries. The treatment promotes movement, reduces pain and restores normal function of the patient's arms, hands and fingers, thus preventing disability.

  1. Brachial Plexus Injuries

    • Many brachial plexus injuries occur during birth. The baby’s shoulders may get caught during the birth process, resulting in the brachial plexus nerves stretching or tearing. Also, brachial plexus injuries can occur as a result of shoulder trauma, tumors or inflammation.

    Symptoms

    • Symptoms of brachial plexus injuries include a floppy or paralyzed arm, no muscle control in the arm, hand, or wrist and no feeling or sensation in the arm or hand. Other patients may feel intense pain from the neck down to the arm on the affected side. Some patients with brachial plexus injuries do not have any symptoms after resting.

    Goals of Physical Therapy

    • For infants you must teach the caregiver how to handle and position, the baby for daily activities. For older children and adults with brachial plexus injuries, physical therapists should improve or maintain the movement in patients' arms, wrists, hands, and fingers, as well as keep their muscles in these areas as strong as possible. Also, the therapist must make sure that the patient with a brachial plexus injury regains or keeps sensation in the affected areas. The physical therapist should prevent contraction of the joints and other deformities that could happen as a result of a brachial plexus injury.

    Physical Therapy Treatment

    • Some type of physical therapy is almost always necessary to recover from a brachial plexus injury. Usually rehabilitation begins as soon as the injury is noticed unless some other physical problems are noticed. Physical therapy may continue for a number of years.
      There are three phases of treatment for brachial plexus injuries. During the acute phase, the physical therapist concentrates on early movement and icing. The physical therapist helps patients improve range of motion to strengthen cervical muscles. In the recovery phase the therapist provides exercises and treatment to strengthen cervical muscles to the prior level of functioning before the injury occurred. Emphasis is placed on muscles supporting the injured brachial plexus nerve. Treatment for the maintenance phase includes a continuation of cervical muscle strengthening and conditioning.
      The frequency of treatment sessions with a physical therapist varies among patients based on the severity of the injury, but each session should not be longer than 60 minutes.
      When tightness occurs, superficial heating of the area with special techniques should be used for 15 minutes, followed by massage before treatment.
      Treatment should be temporarily halted if the patient develops an infectious disease, open wound, or fever.

    Prognosis

    • Recovery depends on the location and severity of the injury in the brachial plexus. In general, sports-related brachial plexus injuries have a good chance of full recovery with physical therapy. Most cases of nerve injury in infants have a good chance of full recovery unless the nerves are torn from the plexus. Severe cases may require surgery.

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