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Pain Relief for Brachial Plexus Injuries

The surgeons at The Institute for Advanced Reconstruction have recently published an article about the outcomes of surgical treatment for brachial plexus injuries in the Journal of Brachial Plexus and Peripheral Nerve Injury. The authors report their experience with brachial plexus reconstruction, concluding that this intervention not only improves function but also provides pain relief.

According to Dr. Andrew Elkwood, the lead author of this manuscript, “The most important goal, which is often overlooked, is to decrease pain. Paralysis can be very painful. Most patient complaints aren’t paralysis, it’s a pain. You know the feeling when you hit your funny bone, and that initial pain takes your breath away. Imagine hitting your funny bone and living with that initial pain 24/7. Alleviating that agony alone is huge.”

A brachial plexus is a group of nerves that come from the spinal cord in the neck and extend down to the shoulder and arm. This network of nerves conducts signals from the spinal cord to the shoulder, arm, and hand. When a person sustains an injury to the shoulder, neck, or arm, the nerves of the brachial plexus may be damaged, causing loss of sensation, paralysis of the arm, or chronic pain.

Most brachial plexus injuries result from trauma to the shoulder. Brachial plexus injuries may also be caused by tumor growth in the area, accidents, or physiological problems present since birth. The nerves of the brachial plexus may also be damaged by exposure to infectious agents, chemotherapy, or radiation from radiation therapy.

Brachial plexus reconstruction may be necessary for patients who are experiencing arm paralysis, pain, or numbness as a result of damage to nerves in the shoulder, neck, or chest. Brachial plexus reconstruction may include the following surgical treatments: nerve repair/decompression, nerve transfer, muscle transfer, tendon transfer, and joint fusion. To learn more about brachial plexus injuries and the surgical treatment options we offer, visit our Brachial Plexus Injuries Program webpage.

This article highlights the outcomes of brachial plexus reconstruction using a muscle transfer procedure. All patients included in this series experienced a significant decrease in pain following treatment. 33% of patients were able to decrease their pain medication use, while 50% of patients were able to discontinue the use of all pain medication. Like any chronic pain, chronic brachial plexus pain may lead to a decreased quality of life, inability to work, psychological distress, and an increased risk for opioid addiction. When patients do not experience improvement from conservative treatment such as physical therapy and anti-inflammatory medications, surgical treatment should be considered. At The Institute for Advanced Reconstruction, our plastic and reconstructive surgeons offer a number of different methods of brachial plexus reconstruction aimed at returning patients to the best quality of life possible.

Interested in reading the full article? See the link below.

Shoulder Subluxation Pain as a Secondary Indication for Trapezius to Deltoid Transfer