Brachial plexus neuropathy is a rare nerve disorder that causes severe pain and weakness in the upper arm and shoulder. It can be caused by various factors and is often misdiagnosed. Diagnosis involves neurological exams, MRI, nerve conduction tests, and nerve biopsies. Treatment options include medication, physical therapy, and rest. Long-term management depends on the patient’s symptoms and can involve regular neurological exams, physical therapy, and medication.
Brachial plexus neuropathy, also sometimes called brachial plexus disease, is a nerve disorder of the brachial plexus, a bundle of nerves that are connected to the shoulder and arm. This condition is characterized by the onset of severe pain in the upper arm and shoulder, followed by regional weakness. It’s relatively rare, and sometimes doctors misdiagnose it as a problem that originates in the cervical spine, such as a slipped or compressed disc, because the brachial plexus nerves originate from this area of the spine.
A number of things can lead to brachial plexus neuropathy, including trauma to the area, strain injuries, tumors pressing on nerves, radiation, congenital anomalies, inflammation, exposure to toxins, and some medications. The level of pain experienced by the patient can vary and patients may also experience tingling and numbness. Initially, the pain may be mistaken for a strain or similar injury, until the patient begins to experience muscle weakness.
Several diagnostic tests can be used to identify brachial plexus neuropathy. A neurological exam of the patient can provide insight into where the patient is having problems. An MRI of the area can reveal physical changes to the nerves, and a nerve conduction test can be used to show that the nerves are not conducting signals correctly and to find out where the communication breakdown is occurring. Nerve biopsies may also be done to look for structural damage to the nerve.
Treatment options for brachial plexus neuropathy vary depending on the cause. If left untreated, it can develop into long-term weakness or paralysis. It can also cause contractures in the shoulder and arm. In other cases, it may resolve itself with rest. Treatments may include changing a course of medication, treating inflammation or infection, physical therapy, and other measures, as appropriate. A neurologist can work with the patient to determine which avenue of treatment might be best.
Some patients may experience long-term problems such as weakness, tingling, or numbness due to brachial plexus neuropathy. Regular neurological exams are a good idea to identify troubling changes such as progression, and the patient may also benefit from physical therapy and some medications that can be used to manage nerve pain. Long-term management options vary depending on the patient and the symptoms the patient experiences, and a neurologist can discuss these in detail after an evaluation.
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