Treatment of brachial plexus lesions (plexitis) in a sanatorium

Brachial Plexitis

Brachial plexitis is a condition caused by damage to the brachial plexus — a network of nerves formed from the anterior branches of spinal nerves. The hallmark of plexitis includes motor, sensory, and trophic disorders. Due to the proximity of the brachial plexus to the mobile structures of the shoulder girdle, it is particularly vulnerable to injuries. Accurate localization of nerve damage can be extremely difficult due to the complex anatomical structure of the plexus.

The brachial plexus is quite large and consists of the first thoracic nerve and the anterior branches of four lower cervical nerves. Occupying a significant area from the lower part of the axilla to the spinal column, and passing above and below the clavicle, its nerve fibers change direction multiple times along their course.

Brachial plexitis brings a great deal of discomfort to the patient and, without timely qualified medical care, often leads to disability. It's not just about loss of work capacity — people may become completely unable to perform everyday tasks. This is largely because the disease typically affects the dominant arm — right for right-handed people and left for left-handed individuals. Losing function in the main hand makes it very hard for patients to retrain the other hand, requiring significant effort, time, and emotional energy. In addition to daily inconvenience, patients suffer from intense pain associated with inflammation of the brachial nerves.

The pain syndrome reaches its peak intensity at night. Even minor movements — such as raising the arm or reaching behind the back — can cause sharp pain. Fine motor skills are significantly impaired, making it difficult to hold small objects, open doors with a key, fasten buttons, etc. In more severe cases, there may be complete numbness, progressive muscle atrophy, paralysis, and paresis.

Causes of Brachial Plexitis

There are many causes of this condition. Among the most common are:

• Compression of the brachial nerves due to prolonged awkward positioning (e.g., bedridden patients, during deep sleep, or while working in uncomfortable positions);
• Injuries to the cervical roots and/or brachial plexus as a result of clavicle fracture, ligament strain, or dislocation of the shoulder joint;
• Micrоtrauma to the brachial plexus accumulated over time (e.g., due to prolonged exposure to vibrations or improper use of crutches);
• Thoracic or cervical osteochondrosis, which frequently provokes the development of radiculoplexitis;
• A number of diseases associated with metabolic disturbances (including gout, diabetes, etc.);
• Birth trauma;
• Contusions, bruises, gunshot or stab wounds to the shoulder joint, upper arm, or neck;
• Diseases of the lymph nodes;
• Costoclavicular syndrome (tumor or subclavian artery aneurysm);
• Cold exposure;
• Infectious diseases, including viral infections (cytomegalovirus, herpes).

Symptoms of Brachial Plexitis

Plexitis manifests itself through paralysis and atrophy of small muscles in the hand and partially in the finger and wrist flexors. Pain occurs in the region of the plexus and on the inner side of the forearm. Sensation is lost in the lower inner part of the arm. In some cases, symptoms such as ptosis (eyelid drooping), miosis (pupillary constriction), and enophthalmos (sunken eyeball) may appear on the same side — signs that indicate possible viral infection.

The pain in plexitis has a characteristic nature: tearing, shooting, boring, or dull aching. In the affected arm, especially in its lower part, symptoms of paresthesia may occur. With infectious-toxic plexitis, reflexes may be weakened or absent, and sensitivity may be impaired.

Vasomotor and trophic disturbances manifest as cyanosis, shiny skin, swelling of the hand, increased sweating, weak radial artery pulse, and nail changes.

Pain resembling brachialgia is usually a sign of the onset of an infectious-toxic process affecting surrounding tissues and spreading to the brachial and cervical plexus.

Diagnosis of Plexitis

An objective diagnosis of plexitis requires special diagnostic methods:

• Electroneuromyography;
• X-ray imaging;
• Ultrasound diagnostics;
• MRI and CT scans;
• Other specialized techniques.

Treatment of Brachial Plexitis

Treatment of plexitis must be comprehensive and always begins after a precise diagnosis and identification of the underlying causes. The goal is to eliminate both the symptoms and the root cause of the condition.

The first stage of treatment involves medication therapy, which includes modern, highly effective drugs such as analgesics, anti-inflammatory medications, nerve conduction recovery agents, circulatory stimulants, tissue nutrition enhancers, and B1 and B12 vitamins.

Depending on the cause and stage of the disease, physiotherapeutic procedures may also be prescribed:

• Cryotherapy and laser therapy;
• Reflexology (various forms);
• Electrophoresis;
• Massage;
• Ozokerite applications;
• Therapeutic exercises;
• Balneological and hirudotherapy treatments;
• Other effective therapeutic procedures.

If the condition is caused by tumors, cervical ribs, aneurysms, or traumatic injury, surgical intervention may be indicated.

Please note that physical overload, cold exposure, and contact with toxic substances are strictly contraindicated for patients suffering from plexitis.

Preventive Measures

As preventive measures, physiotherapy and general strengthening activities are recommended. However, no prevention should replace proper treatment of plexitis, spondylosis, sciatica, and other musculoskeletal conditions at a specialized medical center.

At the “Berezoviy Gai” sanatorium, you will find all the conditions necessary for accurate diagnosis and comprehensive treatment of neurological and musculoskeletal disorders under the supervision of experienced specialists.