Treatment

Treatment depends on several factors including the severity of the injury, the type of injury, the length of time since the injury and other existing conditions.

Nerves that have only been stretched may recover without further treatment.

Your doctor may recommend physical therapy to keep your joints and muscles working properly, maintain the range of motion, and prevent stiff joints.

The healing process sometimes forms scar tissue that must be removed surgically to improve the nerve's function. Surgical repair is often required for nerves that have significant surrounding scar tissue or that have been cut or torn.

Surgery to repair brachial plexus nerves should generally occur within six to seven months after the injury. If nerve surgery occurs more than six to seven months after the injury, the muscles may not recover their function.

Types of surgery

  • Nerve graft. In this procedure, the damaged part of the brachial plexus is removed and replaced with sections of nerves harvested from other parts of your body. This helps restore your arm's function.
  • Nerve transfer. When the nerve root has been torn from the spinal cord, surgeons often take a less important nerve that's still attached to the spinal cord and connect it to the nerve that's no longer attached to the spinal cord.

    In some cases, surgeons may perform this technique at a level close to the targeted muscle in an effort to speed up recovery rather than doing a repair (nerve graft) farther from the muscle. Sometimes doctors may perform a combination of nerve graft and nerve transfer.

    Nerve tissue grows slowly, about an inch (2.5 centimeters) a month, so it can take several years to know the full benefit of surgery. During the recovery period, you must keep your joints flexible with a program of exercises. Splints may be used to keep your hand from curling inward.

  • Muscle transfer. Muscle transfer is a procedure in which your surgeon removes a less important muscle or tendon from another part of your body, typically the thigh, transfers it to your arm, and reconnects the nerves and blood vessels supplying the muscle.

Pain control

Pain from the most severe types of brachial plexus injuries has been described as a debilitating, severe crushing sensation or a constant burning. Narcotic medications are often used initially, but may be changed as your recovery progresses to optimize pain relief.

March 17, 2015
References
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