Old western movies often show the hero taking a wound the shoulder and shrugging it off as “nothing.” This would actually be a very bad place to be wounded, because it contains an important structure called the “brachial plexus.” The brachial plexus is a complex joining and division of several nerve located in the shoulder. It’s formed by the bottom four nerves emerging from the cervical spine (the neck) and the top nerve emerging from the thoracic spine (the mid-back). These join together to form the lateral cord, posterior cord, and medial cord, which then further subdivide into multiple nerves that serve the upper back, chest, shoulder, arm, and hand.
Although direct trauma in the form of penetrating wounds (like the Western hero’s gunshot) can certainly cause brachial plexus injuries, they more commonly result from sudden stretching of the shoulder from the neck, such as a sudden, forceful pull on the arm, or a traumatic event involving landing on the shoulder and upper chest in a way that stretches the shoulder area. One of the most common causes of brachial plexus injuries, in fact, are motorcycle accidents in which the rider is ejected and lands on the ground on their upper chest and shoulder area. The sudden stretching of the shoulder by a seatbelt in a high-speed, front-end impact can also result in brachial plexus injuries.
The consequences of brachial plexus injuries can range from minor to disabling. Depending upon the location and severity of the injury, it may result in symptoms including pain, numbness and tingling up through complete loss of feeling and even paralysis. Because there are so many different muscles and body parts connected through the multiple branches of the plexus, the specific areas affected by brachial plexus injuries can also vary widely.
Treatment for brachial plexus injuries will generally depend upon the severity of the injury and duration of the symptoms. When the nerve have only been mildly stretched, the symptoms will often resolve quickly and completely on their own with no treatment. In somewhat more significant injuries, physical therapy may be helpful in recover. When there is a significant amount of scar tissue formation around the nerve, surgery may be an option to remove the scar tissue and reduce its irritation of the nerves. Where there has been more significant injury to the nerves themselves, surgery in the form of nerve grafts and nerve transfer may help recover sensation and movement, however this must be done before too much muscle-wasting has occured. In situations where there is long-term or permanent pain, medication may be required to control symptoms.
If you or a loved one has suffered a traumatic injury caused by negligence, including a brachial plexus injury, call me now at 916.921.6400.