Overview

A brachial plexus injury is a serious neurological condition that occurs when the brachial plexus—a vital network of nerves extending from the spinal cord in the neck (cervical segments C5 to T1)—is damaged. This intricate bundle of nerves passes through the shoulder region and travels down into the arm and hand, playing a critical role in motor function (enabling movement) and sensory input (allowing touch, temperature, and pain perception) throughout the entire upper limb.

When the brachial plexus is injured, even partially, it can severely disrupt communication between the spinal cord and the muscles of the arm and hand. This often results in varying degrees of muscle weakness, loss of coordination, numbness, tingling, or complete paralysis in the affected arm. The injury may also impair a person’s ability to perform simple daily activities such as lifting objects, writing, or even dressing, significantly impacting their quality of life.

Brachial plexus injuries can range from mild, involving temporary nerve stretching (called neurapraxia), to moderate where axonal disruption occurs (axonotmesis), and in severe cases, there may be complete rupture or avulsion of the nerve root from the spinal cord. These variations in severity influence the extent of functional impairment and determine the type and length of rehabilitation needed. The injury can be isolated or part of a complex trauma involving the shoulder, neck, or spine.

At DMPhysios, a premier rehabilitation clinic in Noida specializing in spine and sports-related conditions, our highly skilled multidisciplinary team offers comprehensive evaluation and personalized treatment plans for individuals with brachial plexus injuries. Recognizing the complexity of this condition, we adopt a patient-centered approach that combines advanced diagnostics, hands-on physiotherapy, nerve stimulation techniques, and post-operative care when needed. Our goal is to restore as much function as possible, relieve pain, and support each patient’s return to an independent and active lifestyle.

Whether the injury results from trauma, sports, surgery, or childbirth, DMPhysios provides expert care from the early stages of diagnosis through to long-term rehabilitation, ensuring that every patient receives the highest quality of attention and support tailored to their unique neurological needs.

Symptoms

The symptoms of a brachial plexus injury can vary significantly based on the severity and location of the nerve damage. Common symptoms include:

• Weakness in the shoulder, arm, or hand
• Numbness or tingling sensations in the upper limb
• Burning or electric shock-like pain
• Paralysis or inability to move the arm or fingers
• Loss of sensation in parts of the upper limb
• Muscle atrophy due to disuse or nerve disconnection
• Drooping shoulder or hand deformities (in long-term cases)

Symptoms may develop immediately after trauma or may worsen over time, especially if there is ongoing compression or inflammation of the nerve roots. Early diagnosis and intervention are essential to prevent permanent disability.

Types of Brachial Plexus Injury

Brachial plexus injuries can be classified based on the location of nerve involvement and the severity of the damage:

1. Neuropraxia (Stretch Injury)

• Most common and least severe
• Temporary disruption of nerve conduction without structural damage
• Recovery typically occurs within weeks or months

2. Axonotmesis

• Moderate injury involving damage to the axons but preservation of connective tissue
• Recovery is possible but takes longer due to the need for axonal regeneration

3. Neurotmesis

• Severe injury with complete disruption of the nerve and its sheath
• Surgical repair is often required

4. Avulsion

• Most serious form, where the nerve root is pulled away from the spinal cord
• Irreversible without surgical intervention like nerve grafts or muscle transfers

5. Erb’s Palsy

• Involves upper brachial plexus (C5–C6)
• Weakness in shoulder abduction, elbow flexion, and external rotation

6. Klumpke’s Palsy

• Involves lower brachial plexus (C8–T1)
• Weakness in hand and wrist, often with a claw-hand deformity

At DMPhysios, accurate diagnosis using clinical tests, imaging (MRI, EMG), and functional assessments allows us to classify the type of brachial plexus injury precisely and build effective rehabilitation strategies.

Causes

There are multiple causes of brachial plexus injury, which may occur during birth or later in life due to trauma or medical conditions.

In Adults:

• Motor vehicle accidents (especially motorcycle crashes)
• Falls or direct trauma to the shoulder or neck
• Sports injuries, especially in contact sports
• Gunshot or stab wounds
• Tumors or inflammation compressing the brachial plexus
• Radiation therapy complications

In Newborns (Obstetric Brachial Plexus Palsy):

• Difficult or prolonged labor
• Shoulder dystocia during delivery
• Use of forceps or vacuum assistance
• High birth weight or breech presentation

Regardless of the cause, the impact on upper limb function can be devastating without proper care. At DMPhysios, we specialize in both pediatric and adult rehabilitation of brachial plexus injuries with a multidisciplinary team.

Risk Factors

Several risk factors increase the likelihood of sustaining a brachial plexus injury, including:

• High-impact trauma (e.g., motorbike accidents)
• Participation in contact sports (e.g., wrestling, rugby, football)
• Difficult childbirth or instrumental deliveries
• Occupational hazards involving repetitive shoulder stress
• Pre-existing tumors or anatomical abnormalities
• History of neck or spinal surgery

Understanding these risk factors allows early intervention, especially for those with recurrent injuries or post-surgical complications. At DMPhysios, we help patients minimize modifiable risk factors through education and preventive strategies.

Treatment

Treatment for brachial plexus injury depends on the severity and nature of the injury. Some injuries may resolve on their own, while others require surgical correction and long-term rehabilitation.

1. Conservative Management

• Rest, activity modification
• Use of slings or orthotics to support the limb
• Pain management through medications
• Steroid injections to reduce inflammation
• Regular physiotherapy and stretching

2. Surgical Treatment

Surgical options are considered when there is no sign of brachial plexus injury recovery within 3–6 months, or when the injury is severe (e.g., avulsion).

• Nerve grafts: Using donor nerves to bridge gaps
• Nerve transfers: Transferring functional nerves to restore motion
• Tendon or muscle transfers: Re-routing muscles for function
• Joint surgeries: To stabilize or reposition the shoulder/elbow

At DMPhysios, we coordinate closely with orthopedic and neurosurgical teams to provide pre- and post-operative rehabilitation for optimal recovery.

Physiotherapy Treatment

Physiotherapy is a cornerstone in the recovery from brachial plexus injury, whether treated conservatively or surgically. At DMPhysios, our therapists follow a structured, evidence-based rehabilitation protocol that is tailored to the patient’s stage of recovery, type of injury, and functional goals.

A. Acute Phase (0–3 months)

Goals: Reduce pain, maintain joint mobility, prevent stiffness

• Passive range of motion (ROM) exercises to prevent contractures
• Shoulder stabilization exercises
• Scapular mobilization and support
• Positioning strategies to avoid joint deformities
• Education on proper limb use and care

B. Subacute Phase (3–6 months)

Goals: Begin active movement, strengthen partially innervated muscles

• Active-assisted and active ROM exercises
• Electrical stimulation to facilitate muscle recruitment
• Gentle strengthening of re-innervated muscles
• Mirror therapy and motor imagery for cortical activation

C. Functional Phase (6–12 months)

Goals: Restore function, coordination, and strength

• Task-oriented activities like dressing, grooming, writing
• Progressive resistance training using bands, weights
• Fine motor skill training (for hand and wrist)
• Functional electrical stimulation (FES)

D. Long-Term Management

Goals: Prevent relapse, improve quality of life

• Ergonomic advice and workplace adaptations
• Participation in recreational or vocational rehab
• Psychological support (coping with disability)
• Community reintegration programs

The DMPhysios team uses a holistic, patient-centered approach including occupational therapy, neurorehabilitation, and home-exercise programs to ensure continuity of care and maximize outcomes for patients with brachial plexus injuries.

Prevention of brachial plexus injury

Although not all cases can be prevented, especially birth-related ones, several steps can reduce the risk of brachial plexus injuries:

• Wearing protective gear during sports and riding
• Safe driving practices and use of seatbelts
• Proper lifting techniques in workplaces
• Prenatal screening and delivery planning in high-risk pregnancies
• Early physical therapy in at-risk infants

Education and awareness go a long way in preventing repeat injuries or long-term complications. At DMPhysios, we emphasize preventive strategies in both clinical and community settings.

Conclusion

A brachial plexus injury can be life-altering, but with timely diagnosis, specialized care, and dedicated rehabilitation, significant recovery is possible. Whether caused by trauma, sports, or childbirth, each case demands a personalized treatment plan that addresses both the physical and emotional needs of the patient.

At DMPhysios, a leading Noida-based clinic focused on spine and sports conditions with patient-centered rehabilitation, we pride ourselves on delivering comprehensive, compassionate, and scientifically grounded care for individuals with brachial plexus injuries. Our multidisciplinary approach combines medical expertise with advanced physiotherapy techniques to help patients regain independence and function.If you or a loved one is dealing with a brachial plexus injury, don’t delay. Early intervention makes a significant difference in outcomes.
Contact DMPhysios today for an expert evaluation and a personalized rehabilitation plan designed to restore strength, mobility, and confidence.