Brachial Plexus Clinic
The Brachial Plexus Clinic at Carilion is bringing a multidisciplinary approach and world-class care to patients at risk of losing arm mobility to nerve damage.
Overview
The Brachial Plexus Program at Carilion is bringing a multidisciplinary approach and world-class care to patients at risk of losing arm mobility to nerve damage. Adults, children and babies who sustain such injuries can have trouble lifting a shoulder or bending an elbow, or even using the hand on their injured side. They might not be able to pick things up or bring a fork to their mouth. Putting on a shirt, reaching for a door handle, or scratching an itch can be a challenge. The brachial plexus is crucial for both sensory and motor function of the arm. Damage to the network, inflicted when the nerves are overstretched, compressed, or torn, can have a range of consequences.
Traumas cause injuries to the network of nerves in the neck that send signals down the arm—a complex known as the brachial plexus. The damage disrupts critical communication between the spinal cord and the affected limb, potentially causing pain, impairment, decreased sensation, or even the loss of use of a shoulder, arm, elbow, or hand. When these injuries happen, time is of the essence. Nerves have a limited ability to regenerate, and muscles will stop working over time if they don’t receive signals sparking them to action. That means there’s a ticking clock on efforts to fix the problem—as little as three to six months before the effects of the injury become irrevocable.
Our Team
How patients are affected can depend on the severity and location of the injury itself—which and how many of the brachial plexus nerves are damaged, and where in the neck the injury occurs. Every patient is different so providing individualized care is at the core of what we do. Making the diagnosis—and developing and executing the right treatment plan—requires the input of specialists in many disciplines. Electromyography and nerve-conduction studies are needed to figure out which nerves and muscles are working or impaired. Physical and occupational therapy sessions are key to improving movement and mobility, as well as tracking progress in recovery of day-to-day function. In some cases, surgery is required to repair, reconstruct, or transfer nerves or tendons.
Treatment Options
Patients make a single appointment to see their surgeons and therapists, the nerve specialists who conduct diagnostic tests, a social worker, and the nurse who coordinates their care. The clinic’s dedicated physical and occupational therapists, who have expertise helping patients recover from brachial plexus injuries, are a critical part of the team. Patients work with these therapists exclusively throughout their time with the clinic. Assessments are conducted at each clinic visit to see how the patient progresses.
Discussions about daily tasks in the patient’s professional and social life provide insights into where the patient has recovered and what functions they’re not going to recover. If necessary, surgical options include nerve repair, reconstruction, and transfer. Repair entails a reconnection of fibers. Reconstruction involves removing injured or scarred tissue in the damaged nerve and replacing it with a graft. And, when a damaged nerve can’t be repaired, nerve transfer allows it to be replaced with a live functioning one nearby.
