Brachial Plexus Palsy: An Overview

Brachial plexus palsy is a condition that results from damage or injury to the brachial plexus, a network of nerves responsible for controlling movement and sensation in the shoulder, arm, and hand. This condition can occur at birth (obstetric brachial plexus palsy) or later in life due to trauma, such as motor vehicle accidents or sports injuries. The severity of the condition varies, with some individuals experiencing mild weakness while others may have complete loss of function in the affected limb. 

Causes and Symptoms of Brachial Plexus Palsy 

Brachial plexus palsy is often caused by: 

• Birth Trauma – Difficult deliveries, shoulder dystocia, or excessive pulling on the baby’s head and neck during birth can lead to nerve damage. 

• Trauma and Accidents – High-impact injuries, such as those from motorcycle accidents, falls, or contact sports, can stretch, compress, or tear the brachial plexus nerves. 

• Tumours and Inflammation – In rare cases, tumours or inflammatory conditions can affect the brachial plexus, leading to nerve impairment. 

Symptoms of brachial plexus palsy depend on the extent of nerve damage and may include: 

• Weakness or paralysis in the affected arm 

• Loss of sensation or numbness 

• Decreased grip strength 

• Limited movement in the shoulder, elbow, or hand 

• Pain or discomfort in the affected area 

How Can Physiotherapy Help? 

Physiotherapy is a key component in the management and rehabilitation of brachial plexus palsy, helping to restore movement, strength, and function. A physiotherapist can assist in several ways: 

1. Pain and Inflammation Management 

• Manual Therapy – Gentle massage and mobilisation techniques can improve circulation and reduce stiffness. 

• Electrotherapy – Techniques such as transcutaneous electrical nerve stimulation (TENS) and ultrasound therapy can help manage pain and promote healing. 

2. Improving Range of Motion and Flexibility 

• Passive and Active Range of Motion Exercises – These help prevent joint stiffness and maintain flexibility in the affected limb. 

• Stretching Programs – Specific stretches can target tight muscles and improve overall movement. 

3. Strengthening and Functional Rehabilitation 

• Targeted Strengthening Exercises – Strengthening the muscles surrounding the shoulder, arm, and hand can compensate for nerve deficits. 

• Task-Specific Training – Exercises tailored to daily activities can help improve independence and functionality. 

• Mirror Therapy and Neuromuscular Re-Education – Techniques that promote brain-muscle communication to enhance recovery. 

4. Adaptive Strategies and Assistive Devices 

• Splinting and Bracing – Supportive devices may be recommended to maintain proper joint positioning and prevent contractures. 

• Activity Modification – Physiotherapists can provide guidance on adapting daily tasks to accommodate functional limitations. 

When to Seek Physiotherapy 

Early intervention is crucial for individuals with brachial plexus palsy. Seeking physiotherapy as soon as possible can enhance recovery outcomes by preventing complications such as muscle atrophy and joint contractures. 

Conclusion

Brachial plexus palsy can significantly affect arm function and daily activities, but physiotherapy plays a vital role in rehabilitation. Through pain management, mobility exercises, strengthening programs, and adaptive strategies, physiotherapists help individuals regain function and improve their quality of life. If you or a loved one is affected by brachial plexus palsy, consulting a physiotherapist can provide valuable support on the journey to recovery.