After a car accident, many people experience neck and shoulder pain that radiates into the arm. The neck is treated for the tearing and stretching of the ligaments, but the arm pain and hand pain continues. The MRI is negative for a herniated disc, but the patient still has problems from the car accident. A good doctor will investigate whether this patient has a brachial plexus injury. A brachial plexus injury usually happens when your shoulder is pressed down forcefully while your head is pushed up and away from that shoulder (a typical action in a seat-belted rear-end car accident victim).
A brachial plexus injury is an injury to the network of nerves that runs from the spine through the neck into the arm. There are four types of brachial plexus injuries: avulsion (the most severe type in which the nerve is torn from the spine); rupture (the nerve is torn but not at the spinal attachment); neuropraxia (nerve has been damaged but not torn); and neuroma (nerve has tried to heal itself but scar tissue has grown around the injury). Whatever the type of brachial plexus injury, it needs to be treated to prevent permanent restrictions and limitations.
To help diagnose the extent and severity of a brachial plexus injury, you may have one or more of the following tests: Electromyography; Nerve conduction studies; Magnetic resonance imaging (MRI); or Computerized tomography (CT) myelography.
The scar tissue that develops because of a brachial plexus injury sometimes 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. The type of surgeries include nerve graft (the damaged part of the brachial plexus is removed and replaced with sections of nerves cut from other parts of your body) or a nerve transfer (surgeons take a less important nerve that's still attached to the spinal cord and hook it into the nerve that's no longer attached). Partly because of the risk of muscle atrophy, surgery to repair brachial plexus nerves should ideally occur within three to six months after the injury. The success rate drops greatly if nerve surgery occurs more than a year after the injury.
Brachial plexus injuries can cause permanent weakness or disability. Don't take them for granted, even if they seem minor. See your doctor if you have recurrent burners and stingers, weakness in your hand or arm that lasts more than a few days, neck pain, or symptoms in both arms.
If you are suffering from shoulder, arm and/or hand pain from a car accident, motorcycle accident, or other injury, talk to your doctor about the possibility of having a brachial plexus injury. It is better to be safe than sorry.
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