United Brachial Plexus Network, Inc.

Hi there

Last Sunday I had a horse riding accident where my horse stopped at a jump and I flew head first into the ground the other side. I suffered a concussion and bruised face. They thought I had injured my spinal cord or brain but xray, CT and MRI were clear.

What I noticed while I was waiting to go to casualty was a numb tingling sensation in my left hand and arm. By the time I go to the hospital my arm was limp and any movements were difficult and clumsy.

I have seen a physio and she has said I stretched the brachial plexus nerve. I have reasonable movement in my arm but my sensations are impaired. The one thing that is confusing me though is that my fingers 'pop'. When I try make a fist they get to a certain point and then pop down to the closed position. When I open my fist they move to a certain position and then pop up. It only happens with my outer three fingers. I battle to close the index finger and bring the thumb around. Does anyone have an explanation for this?

It sounds like spasticity brought on by flexion and extension. Typical when nerves are damaged. Has your PT seen you have this? Or doctor?

Marieke 32, LOBPI

I have shown my neurologist and PT but they seem more concerned about me lossening my shoulder through stretches.

I'm a bit annoyed because their main concern when I was admitted was spinal injury so very little was recorded about my arm. It is understandable considering the nature of the fall but because very little was recorded I have to try explain how it felt through memory. Which is a bit hard because of my concussion.

I find it is worse in the morning or after long periods on inactivity. I find I can use my arm (even pick things up) but it doesn't feel like my arm. It feels weak, stif and awkward even though I can move it.

Just to add: my hand also sweats a lot. I find that if I don't keep it warm it swells up and turns a blue blotchy colour.

My doc mentioned that the nerve may be pinched or pressurised because of tissue damage and swelling. What is the likely hood of that in your opinion? I am seeing him next Friday when he will rum some more tests - he wants the swelling to go down. Is there anything in particular I should ask him, or enquire about?

If you are not moving your hand as much then yes, there could be swelling and if it is blue/blotchy, it's cold and the blood is not circulating well. The movement of muscles are what help the veins return the blood to the heart. So, less muscle movement means less venous return, which equals swelling, cold, hand.

The spastic hand/fingers would be worse in the morning and after periods of inactivity. Unfortunately there is not much you can do apart from stretching and using it. There are meds, but they don't work well on upper extremity spasticity (baclofen). The spasticity us due to the spinal cord damage. It may or may not improve.

Try to keep your hand/arm moving, passively stretch it, keep it elevated as much as possible.

If your MD things you have a pinched nerve or there is swelling on the nerve causing pressure, has he mentioned giving you steroids to decrease it? Prednisone (Oral) ?

Feel free to email me too,
Marieke RN 32, LOBPI