Brachial Plexus Injury: Symptoms, Causes, and Treatment

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

A doctor and patient discuss shoulder and arm symptoms, with a brachial plexus anatomy diagram on the wall behind them.

Quick Answer: What is a brachial plexus injury?

A brachial plexus injury is damage to the nerve network carrying signals from the spinal cord to the shoulder, arm and hand, ranging from a temporary stretch to a full tear. It causes burning or shock-like pain, numbness and weakness, and is often caused by contact sports, birth complications, falls or vehicle accidents. Treatment ranges from physical therapy to surgery.

What the research says

• Double nerve transfers did better for shoulder function. A meta-analysis of 29 studies and 393 patients with traumatic brachial plexus injuries found that double transfers consistently outperformed single transfers for abduction and range of motion. Older age and longer denervation time were linked to poorer outcomes, and partial plexus injuries recovered better than total ones (Guerra et al., J Clin Neurosci, 2025) [7].

• Tendon transfers had fewer complications than shoulder fusion. In a review of 22 studies (269 tendon transfers and 194 shoulder arthrodesis procedures), the pooled complication rate was 4.8% after tendon transfer versus 26.4% after arthrodesis, and the reoperation rate was 3.2% versus 17%. Mean shoulder abduction was 81° versus 51° (Lauck et al., J Clin Med, 2025) [8].

• Pain is common, and reporting of it is inconsistent. A systematic review of 9 studies found pain was consistently prevalent after brachial plexus injury, particularly with root avulsion, and several surgical techniques were linked to pain improvement. More than 15 different postoperative time points were used, which prevented pooled analysis (Zakusylo et al., Cureus, 2026) [9].

Study details are from PubMed abstracts.

What is the brachial plexus?

The brachial plexus is the group of nerves that sends signals from the spinal cord to the shoulder, arm, and hand. Think of it as the wiring for your upper limb. When that wiring is stretched, squeezed together, or torn apart, the signals that move the arm and carry feeling break down.

The most serious brachial plexus injuries happen during car or motorcycle accidents. Bad injuries can leave the arm paralyzed, but surgery may help.

Brachial plexus injuries fall on a spectrum. A stretch (stinger) heals on its own, a rupture needs repair, and an avulsion, where the root tears from the cord, is the most serious.

What are the symptoms of a brachial plexus injury?

Symptoms of a brachial plexus injury can differ depending on how serious the injury is and where it is located. Usually only one arm is affected.

Less severe injuries

Minor damage often happens during contact sports, such as football or wrestling, when the nerves get stretched or squeezed together. These injuries are called stingers or burners.

The typical signs are a feeling like an electric shock or a burning sensation shooting down the arm, along with numbness and weakness. These symptoms usually last only a few seconds or minutes, but in some people they may last for days or longer.

More serious injuries

More serious symptoms appear when the injury badly damages, tears, or ruptures the nerves. The most serious brachial plexus injury is when the nerve root is cut or torn from the spinal cord. Symptoms can include:

• Weakness or an inability to use certain muscles in the hand, arm, or shoulder.

• Loss of feeling in the arm, including the shoulder and hand.

• Intense pain.

When to see a doctor

Brachial plexus injuries can cause lasting weakness or disability. Even if yours seems minor, you may need medical care. See your healthcare provider if you have:

• Burners and stingers that keep coming back, or symptoms that do not go away quickly.

• Weakness in the hand or arm.

• Neck pain.

• Symptoms in both arms.

What causes a brachial plexus injury?

Upper brachial plexus injuries happen when the shoulder is forced down on one side while the head is pushed the opposite way. The lower nerves are more likely to be injured when the arm is forced above the head. These injuries can happen in several ways:

Cause	How it happens
Contact sports	Many football players get burners or stingers when the nerves are stretched past their limit during clashes with other players
Birth	Newborns can be injured during delivery, especially with high birth weight, a very long labor, a breech position, or when the baby's shoulders get stuck in the birth canal
Accidents and trauma	Motor vehicle accidents, motorcycle accidents, falls, and bullet wounds can all damage the brachial plexus
Tumors and cancer treatments	Tumors can grow on their own or, rarely, form because of a condition such as neurofibromatosis or after radiation treatment

One birth-related injury has its own name. When a baby's upper nerves are injured, it is called Erb palsy.

What are the risk factors for a brachial plexus injury?

Playing contact sports, especially football and wrestling, or being in high-speed motor vehicle accidents increases the risk of brachial plexus injury.

What complications can a brachial plexus injury cause?

Many mild brachial plexus injuries heal over time with few to no issues. But some injuries cause short-term or lasting problems:

Complication	What happens
Stiff joints	Hand or arm paralysis lets joints stiffen, making movement hard even after use returns; ongoing physical therapy may be suggested
Pain	Caused by nerve damage, and it may be lifelong
Numbness	Lost feeling raises the risk of burning or injuring yourself without knowing it
Muscle atrophy	Nerves regrow slowly over many years; unused muscles break down during that time
Permanent disability	Recovery depends on age and the type, location, and seriousness of the injury; even with surgery, some weakness or paralysis can last a lifetime

How is a brachial plexus injury diagnosed?

A brachial plexus injury is diagnosed with a symptom check and a physical exam. To know how serious the injury is, one or more of the following tests may be needed:

Diagnostic test	What happens	What it shows
X-ray	Images of the shoulder and neck	Fractures or other related injuries
Electromyography (EMG)	A needle electrode is placed through the skin into different muscles; most people finish with little discomfort	Electrical activity of muscles at rest and when tightening
Nerve conduction studies	Usually done as part of EMG	How fast and how well electrical signals travel down the nerves
MRI	A powerful magnetic field and radio waves create detailed images	The extent of plexus damage and any artery damage in the limb, which matters for reconstruction; newer types include magnetic resonance neurography and diffusion tensor imaging
CT myelography	Contrast dye is injected during a spinal tap, then CT X-rays are taken	Issues in the spinal cord and nerve roots; used when MRIs do not give enough information

What are the treatment options for a brachial plexus injury?

Treatment depends on many factors, such as the seriousness of the injury, the type of injury, the length of time since the injury, and other existing conditions.

Nerves that have only been stretched may heal on their own. Your healthcare team may suggest physical therapy to keep the joints and muscles working properly, maintain range of motion, and prevent stiff joints.

Surgery is often the best option for serious nerve injuries. In the past, surgery was sometimes delayed to see if the nerves would heal on their own. However, new research shows that delaying surgery by more than two to six months could make the repair less successful. New imaging techniques can help your healthcare team decide when surgery would be most beneficial.

Nerve tissue grows slowly, so it can take many years before you see the final results of surgery. During recovery, exercises keep your joints flexible, and splints may be used to keep the hand from curling inward.

Types of surgery

Procedure	How it works
Neurolysis	Frees up the nerves from scar tissue
Nerve repair	Directly repairs nerves injured by sharp objects, such as knives; rarely done for stretched fibers
Nerve graft	Nerves from other parts of the body replace the damaged part of the brachial plexus, creating a bridge for new nerve growth over time
Nerve transfer	When the root has been torn from the spinal cord, a less important working nerve is connected to a more important nonworking nerve; most helpful for avulsions and may speed muscle recovery since the reconstruction is close to the muscle
Muscle transfer	A less important muscle or tendon, most often from the inner thigh, is moved to the arm with nerves and blood vessels reconnected; a skin flap may help surgeons check blood supply at the new site

Five surgical approaches restore movement after a serious brachial plexus injury, from freeing nerves trapped in scar tissue to transferring healthy muscle from another part of the body.

Pain control

Serious brachial plexus injuries can cause extreme pain. The pain has been described as a debilitating, severe, crushing feeling or a constant burning. This pain goes away within three years for most people.

If medicine cannot control the pain, your healthcare team might suggest surgery to interrupt the pain signals coming from the damaged part of the spinal cord.

What can you do after a brachial plexus injury?

Although a brachial plexus injury cannot always be avoided, you can take steps to reduce the risk of complications after getting hurt.

• If you cannot use the hand or arm for a short time, daily range-of-motion exercises and physical therapy can help prevent joint stiffness.

• Avoid burns or cuts, since numbness means you may not feel them.

• Athletes with a brachial plexus injury may be advised to wear padding to protect the area when playing sports.

• If your child has brachial plexus palsy, exercise your child's joints and working muscles every day. You can start when your baby is just a few weeks old. This helps stop the joints from becoming permanently stiff and keeps the working muscles strong and healthy.

How should you prepare for a brachial plexus injury appointment?

Preparing for a brachial plexus injury appointment means asking about test preparation, bringing a family member or friend, and listing your symptoms and medicines.

• Many tests may be used to help diagnose brachial plexus injuries. When you make your appointment, ask whether you need to prepare for these tests. For example, you may need to stop taking certain medicines for a few days or avoid using lotions the day of the test.

• If possible, bring a family member or friend. Sometimes it is hard to remember all the information given during an appointment.

• Write down all your symptoms, including how you were injured, how long you have had them, and whether they have gotten worse over time.

• Make a list of all medicines, vitamins, and supplements you are taking.

• Children and adults with brachial plexus injuries have many options for restoring movement. Ask your healthcare team about all the possibilities available. If you run out of time, ask to speak with a nurse or have a member of your care team call you later.

What is the bottom line on brachial plexus injury?

A brachial plexus injury is essentially a break in the wiring that moves and feels for your arm, and how much wiring is broken decides how it heals. A stinger from a football collision usually fades in minutes, while a nerve root torn from the spinal cord in a motorcycle crash can demand surgery within months to give repair its best chance.

The good news is that treatment keeps improving. New imaging helps teams time surgery precisely, nerve transfers can reroute working nerves to dead ones, and even muscle transfers can rebuild movement. Physical therapy, daily range-of-motion exercises, and smart safety habits protect the arm throughout recovery.

If you have arm weakness, numbness, or burning after an injury or a sports hit, do not write it off. See a healthcare provider, especially if symptoms keep returning, neck pain joins the picture, or both arms are involved.

Next steps: If you or your child have arm or shoulder symptoms after an injury, seek medical evaluation rather than waiting for them to pass.

FAQ

What does a brachial plexus injury feel like?

Most people describe an electric shock or burning sensation shooting down the arm, along with numbness and weakness. In serious injuries, symptoms include an inability to use certain muscles in the hand, arm, or shoulder, loss of feeling, and intense pain.

Do brachial plexus injuries heal on their own?

Nerves that have only been stretched may heal on their own, and minor stingers often fade within seconds or minutes. Serious tears and ruptures usually need surgery, and delaying repair beyond about two to six months can make it less successful.

What is Erb palsy?

Erb palsy is a brachial plexus injury in newborns where the upper nerves are damaged during birth, which is more likely with high birth weight, a long labor, a breech position, or when the baby's shoulders get stuck in the birth canal.

Can surgery restore movement after a serious injury?

Yes. Options include freeing nerves from scar tissue, directly repairing torn nerves, bridging gaps with nerve grafts, rerouting less important nerves through nerve transfers, and moving a healthy muscle, often from the inner thigh, to the arm through muscle transfer.

How long does the pain from a brachial plexus injury last?

Severe pain from a serious injury, described as a crushing or constant burning feeling, goes away within three years for most people. If medicine cannot control it, surgery to interrupt the pain signals from the damaged part of the spinal cord may be suggested.

Disclaimer: This article is for general informational purposes only and does not constitute medical advice. Always consult a qualified health care provider for individual questions.

References

1. Mayo Clinic Staff. Brachial plexus injury - Symptoms and causes. Mayo Clinic. March 27, 2024. https://www.mayoclinic.org/diseases-conditions/brachial-plexus-injury/symptoms-causes/syc-20350235

2. Mayo Clinic Staff. Brachial plexus injury - Diagnosis and treatment. Mayo Clinic. March 27, 2024. https://www.mayoclinic.org/diseases-conditions/brachial-plexus-injury/diagnosis-treatment/drc-20350241

3. National Institute of Neurological Disorders and Stroke. Brachial Plexus Injury. National Institute of Neurological Disorders and Stroke. Last reviewed March 13, 2026. https://www.ninds.nih.gov/health-information/disorders/brachial-plexus-injury

4. American Academy of Orthopaedic Surgeons. Brachial Plexus Injuries. OrthoInfo. Accessed October 14, 2026. https://www.orthoinfo.org/diseases--conditions/brachial-plexus-injuries/

5. Guerra PLN, et al. Evaluation of nerve transfer techniques for shoulder function recovery in traumatic brachial plexus injuries: A Systematic review and individual patient data meta-analysis. J Clin Neurosci. 2025;142:111704. PMID 41218420. https://doi.org/10.1016/j.jocn.2025.111704

6. Lauck BJ, et al. Differentiating Outcomes and Complications Between Extraplexal Tendon Transfers and Arthrodesis for Shoulder Reanimation Following Traumatic Brachial Plexus Injury: A Systematic Review and Proportional Meta-Analysis. J Clin Med. 2025;14(22). PMID 41302948. https://doi.org/10.3390/jcm14227911

7. Zakusylo A, et al. Pain After Brachial Plexus Injury Surgery: Variability in Reporting. Cureus. 2026;18(1):e102144. PMID 41737096. https://doi.org/10.7759/cureus.102144