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Causes
By Mayo Clinic staff
The nerves that make up the brachial plexus exit your spinal cord near the point where your neck joins your shoulder. They pass behind your collarbone (clavicle), dividing and recombining as they travel down your arms until they reach the tips of your fingers. The nerves that emerge higher in your neck serve your shoulder and elbow, and nerves that emerge lower in your neck serve your forearm and hand.
Damage to the upper nerves tends to occur when your shoulder is forced down, and your neck stretches up and away from the injured shoulder. The lower nerves are more likely to be injured when your arm is forced above your head. These injuries can occur in several ways:
- Contact sports. Many football players experience burners or stingers, which can occur when the nerves in the brachial plexus get stretched beyond their limit during collisions with other players.
- Difficult births. Newborns can sustain brachial plexus injuries when there are problems during birth, such as a breech presentation or prolonged labor. If an infant's shoulders get wedged within the birth canal, the force used to pull the baby free also can damage the nerves in the brachial plexus. Most often, the upper nerves are injured, a condition called Erb's palsy. Total brachial plexus birth palsy occurs when both the upper and lower nerves are damaged.
- Trauma. Vehicular accidents, especially motorcycle accidents, and boating accidents can result in brachial plexus injuries. Animal bites and bullet or knife wounds also can damage the brachial plexus.
- Brachial plexus injury (Erb's palsy). American Society for Surgery of the Hand. http://www.assh.org/Content/NavigationMenu/PatientsPublic/HandConditions/BrachialPlexusInjury/Brachial_Plexus_Inj.htm. Accessed Oct. 24, 2008.
- Burners and stingers. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=226&topcategory=Shoulder. Accessed Oct. 24, 2008.
- NINDS brachial plexus information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/brachial_plexus/brachial_plexus.htm. Accessed Oct. 24, 2008.
- Erb's palsy (brachial plexus birth injury). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=314&topcategory=Shoulder. Accessed Oct. 24, 2008.
- Shin AY, et al. Adult traumatic brachial plexus injuries. Journal of the American Academy of Orthopaedic Surgeons. 2005;13(6):382-396.
- Uehara DT et al. Injuries to the Shoulder Complex and Humerus. In: Tintinalli JE et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. Chapel Hill, N.C.: The McGraw-Hill Companies; 2004. http://www.accessmedicine.com/content.aspx?aID=612543&searchStr=injury+of+brachial+plexus. Accessed Nov. 11, 2008.
- McMahon PJ et al. Sports Medicine: Shoulder Neurovascular Injury. In: Skinner HB. Current Diagnosis & Treatment in Orthopedics. 4th ed. Irvine, Calif.: The McGraw-Hill Companies; 2006. http://www.accessmedicine.com/content.aspx?aID=2319261&searchStr=injury+of+brachial+plexus. Accessed Nov. 11, 2008.
