CHILDREN · Health guide
Brachial Plexus Injury and Rehabilitation
Arm weakness and sensory changes in brachial plexus injury: nerve assessment, rehabilitation and the follow-up process.
Updated: · General information
What is it?
The brachial plexus is the network of nerves running from the neck into the arm. Birth-related injury or trauma can alter movement and sensation in the arm.
How is it assessed?
Shoulder, elbow, wrist and finger movements are examined. The grade of the injury and the course of recovery are monitored; nerve studies or a surgical opinion are requested where needed.
How is rehabilitation planned?
The plan covers preserving joint movement, age-appropriate active use and training in safe handling. Forceful stretching of the baby’s arm must be avoided; the home programme should be demonstrated on the basis of the examination.
Which movements may be affected?
Depending on where the damage lies in the network of nerves running from the neck to the arm, shoulder, elbow, wrist and hand movements may be affected to differing degrees. Birth-related injuries and injuries in adults are not assessed in the same way. Muscle strength, sensation, joint movement and pain are recorded; the physician decides on the timing of EMG or imaging.
Which changes matter during follow-up?
Monitoring newly emerging voluntary movements and everyday use helps in updating the programme. Work aimed at preventing joint stiffness must be consistent with the state of nerve recovery and with any surgical restrictions. Carers are taught appropriate handling so that forceful manoeuvres, such as lifting the child by pulling on the affected arm, are avoided.
Your questions
Patient information
Does the nerve recover completely?
The outcome depends on the type and severity of the damage. Some injuries require surgical assessment; simply waiting for time to pass may not be appropriate.
Should reduced movement of one arm in a baby be left to resolve on its own?
No. Early assessment by a paediatrician and the relevant specialist is needed; the family should not carry out stretching or forceful manoeuvres on their own.
