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 provider may recommend physical therapy to keep the joints and muscles working properly, maintain range of motion, and prevent stiff joints.
Surgery to repair brachial plexus nerves should generally occur within six months after the injury. Surgeries that occur later than that have lower success rates.
Nerve tissue grows slowly, 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 the hand from curling inward.
Types of surgery Nerve graft Open pop-up dialog box Close Nerve graft Nerve graft
Nerve tissue can be removed from other parts of the body to replace the damaged portions of the brachial plexus nerves.
Nerve transfer Open pop-up dialog box Close Nerve transfer Nerve transfer
Nerve transfers are particularly helpful in the most serious types of brachial plexus injuries, called avulsions, when the nerve root has been torn out of the spinal cord. They may also be used when surgeons are trying to speed up muscle recovery. Because the nerve reconstruction is often close to the muscle, nerve recovery may be faster and perhaps better than other techniques.
Muscle transfer Open pop-up dialog box Close Muscle transfer Muscle transfer
If the arm muscles have atrophied from lack of use, a muscle transfer may be needed. The most commonly used donor muscle is in the inner thigh. A section of skin and tissue attached to the donor muscle may also be removed. This skin flap can help the surgeons monitor whether the muscle is getting enough blood after it has been transferred to its new location.
- Neurolysis. This procedure consists of freeing up the nerve from scar tissue.
- Nerve graft. In this procedure, the damaged part of the brachial plexus is removed and replaced with sections of nerves taken from other parts of the body. This provides a bridge for new nerve growth over time.
- Nerve transfer. When the nerve root has been torn from the spinal cord, surgeons often take a less important nerve that's still working and connect it to a nerve that's more important but not working. This provides a bypass for new nerve growth.
- Muscle transfer. Muscle transfer is a procedure in which your surgeon removes a less important muscle or tendon from another part of the body, typically the thigh, transfers it to the arm, and reconnects the nerves and blood vessels supplying the muscle.
Pain from the most severe types of brachial plexus injuries has been described as a debilitating, severe crushing sensation or a constant burning. This pain resolves for most people within three years. If medications can't control the pain, your provider might suggest a surgical procedure to interrupt the pain signals coming from the damaged part of the spinal cord.