Brachial Plexus Treatments

No Treatment

• For some with brachial plexus injuries, the best treatment option is to let it heal naturally. This is usually the option for babies who are born with the injury, and only need three to four months to heal. Other patients may heal in weeks or months, depending on the extent of the injury. Whether treatment is needed depends upon the severity of the injury. An avulsion is a type of injury that occurs when the nerve root is detached from the spinal cord. If the avulsion is incomplete, the nerve is not completely severed, and it may be able to heal slowly on its own. Another type of injury is a rupture, which occurs when the nerve is torn but in a place other than where it connects to the spine. Neuropaxia is a less severe injury which occurs when damage is done to the protective cover over the nerve. In this type of injury, the nerve is not damaged, but its ability to function, as a signal conductor, is harmed. Most patients with this type of injury can heal without surgery or therapy. Patients that have complete avulsions or ruptures, however, will not usually heal without the nerve being reconnected surgically.
  
  

Physical Therapy

• Physical therapy for brachial plexus usually involves range of motion exercises and medications and treatments that are used to relieve pain. Physical therapy is often recommended in order to help people maintain or gain strength in muscles. Patients are usually put on a physical therapy regime for between three and eight weeks. Patients do motion exercises, which help to get rid of stiffness in the arm and give flexibility to the joints. For one arm exercise, sit with your palms pointed upward and then bend your fingers inward. Do this between three and ten times. For another exercise, bend your arms at your elbow and touch your shoulder, making sure to keep your fingers flexed.
  
  Some doctors may also recommend stints and braces, which are meant to help people have greater movement in their arms and hands. If the deltoid muscle is weakened by a brachial plexus injury, doctors will put a sling on patients' arm to avoid injury to the humerus. For pain, some patients may be given medications such as cortcoisteroids, anti-inflammatory medications, analgesics, muscle relaxants anti-seizure medications or tricyclic antidepressants.
  
  

Surgery

• If a patient does not recover from his injury within three to six months and no later than a year, doctors will usually recommend surgery. Doctors may perform nerve grafts, nerve transfers or muscle transfers. A nerve graft is a procedure in which nerve tissue is placed into a gap that is left when nerves are ruptured or stretched. The nerve tissue comes from harvesting tissue from other parts of the body, usually the elbow or lower legs. After this, the nerves grow around the tissue, usually around an inch a month, making recovery a slow process. A nerve transfer is when part of a functioning brachial plexus is used to replace a nerve or muscles that are damaged near the spine. This is done to give these muscles or nerve motor and sensory function. During the procedure, the functioning part of the brachial plexus is sewn onto the nerve or muscles that are not working. During muscle transfers, a healthy muscle, as well as its nerves and blood supply, from the leg is grafted onto the place on the arm that is not functioning. The goal of this surgery is to bring motor function to the shoulder, elbow and hand. Although these surgical procedures can help to allow movement back into the arm, shoulder and hand, it only partially restores the hand's ability to grip objects. Sometimes a number of surgical procedures need to be done in order to give the hand greater grasping ability.