United Brachial Plexus Network, Inc.

At this point I think I have a Brachial Plexus injury, but the doctors aren't certain... hoping for some help....

Injury was first noticed in late December 2011. Not sure exactly how it happened, but I noticed that my ability to do push ups was starting to decrease from about 50 in a minute to approximately 30. I began to work on my push ups more as a consequence and then noticed some sharp pains in my armpit. From there things got worse, I began to notice that if my arm was bent at the elbow, I was unable to raise my arm from my side. Went to physical therapy, where they were unable to diagnose my injury so they encouraged me to go to orthopedic type doctor.

Had a couple of MRI's that showed a normal shoulder with a little bit of excess fluid, they gave me a lidocaine injection which provided immediate relief. However, the very next day, I couldn't lift my shoulder in any direction past 15 degrees. They then had me undergo exploratory surgery where they "fixed" my bicep's tendon which was severely inflamed. It seems the surgery just tried to fix a symptom, not the root cause.

Needless to say, here I am 6 months since I noticed the injury with significant atrophy a very slightly improved shoulder (still can't lift my arm properly) and constant pain. Its not significant stabbing pain all the time, but I constant ache that gets the best of me every now and then. On top of all that, due to my nerve issues, it looks like my shoulder might freeze because I can't heal properly from the surgery. The neurologist says that the EMG shows that its possibly due to do with my brachial plexus, and has referred me to a specialist. I've attached a link to my youtube video that details some other weird symptoms. I'm just tired of my arm not working properly and no one knowing why. Anyone have any thoughts?

Link to my video: http://youtu.be/7RgQQDZXE-Q

Andrew,
Thanks for posting the video. Smart proactive move!

From the movement restrictions that come from hand positions I'd say it's pretty clear that you have some kind of nerve impingement going on in your shoulder area of the Brachial Plexus. The fact that bending the elbow then limits your ability to raise/abduct your arm/shoulder illustrates this all even more clearly.

The question is what is causing these impingements?

The fact that after you received a steroid lidocaine shot (which will temporarily reduce swelling which can be the cause of your impingement) you had free range of movement again, but it was worse the next day makes it clear (to me) that something is restricting, pinching, impinging part of your Brachial Plexus some how. There are a number of ways this can happen; a neuroma that would then cause nerve movement restriction & impingement (the nerve must be able to move/glide between muscles etc as you pull on it by changing postion of the arm/hand/elbow etc), muscle enclosure/trapping nerve, bone to muscle entrapment of nerve, nerve inflammation causing restricted movement, and more causes that I don't know of yet.

To me this is promising. Because it is a matter of deduction and most likely remediable.

There are a number of things that I recommend:

(Google any of these suggestions below to read studies, testaments, and recommendations of dosages etc)

Nourish your nerves;
-Omega-3s,
-Vitamin B-Complex
-Heavy on the B6 especially. Pre-injury I had carpal tunnel so bad from kayaking down the Colorado River for 2 weeks, that I had to tape my hands to the paddle shaft. I could barely ride my motorcycle back from Utah to LA because of hand numbness and wrist flection. A pharmacist/body builder recommended it, and it worked great within a week.
-Healthy Diet (research nerve inflammation and dietary casuses & remedies. It's a serious reality very often ignored. No sugars, very low carbs, think Paleo Diet or Atkins type with good attention to darkest colored fruits & vegetables; spinach, blueberries etc).

Nerve Flossing:
-This is something I found out late in the game with my injury, but in my case it didn't matter as much. In your case, I think you should be diving into this.
- example http://www.youtube.com/watch?v=7xi_yAWCqhI / http://www.nervemobilization.com & http://www.nervemobilization.com/how-nerves-cause-pain
- example of "nerve tethering" http://www.youtube.com/watch?v=yWWHLdVH ... r_embedded & http://www.youtube.com/watch?v=CtkYvH5U ... el&list=UL

Proper Medical Attention:
-don't waste time dealing with "good" doctors, find the best. Nerves are tricky and the 'best' local neurosurgeon in your area might not know a thing when dealing with proper diagnosis and attention to a Brachial Plexus Injury. It's an unfortunate reality. Your injury seems non-traumatically induced, so you should be seeking out the "why this injury happened" to find the best resolve. It may be purely physiologically caused by your genetics (natural entrapment/impingement caused by the specifics of your specific anatomy).
-Find a BPI specialist close to your area. http://ubpn.org/index.php?option=com_ph ... d%20States
-The best I know of is the Mayo Clinic's BPI Team in Rochester, MN

-FYI Diagnostic Imaging for nerves is virtually non-existant. Most MRI, CT SCANS, PET SCANS, etc can't capture images and damage to nerves, hence exploratory surgeries and EMT to assess nerve conductivity. MR Neurography is the only technology that I'm aware of that can positively image nerves.

MR Neurography is a technology that reconfigures a MRI data to image the nerves.
http://en.wikipedia.org/wiki/Magnetic_r ... eurography
http://www.mayoclinic.org/medicalprofs/ ... e-mri.html
http://www.ncbi.nlm.nih.gov/pubmed/18796657
http://www.nejm.org/doi/full/10.1056/NEJMc0902318
http://www.nervemed.com/brachial-plexus ... formation/
http://onlinelibrary.wiley.com/doi/10.1 ... 22240/full


Your situation is going to take some continual investigation on your end because the nature of how it developed. I've been dealing with the BPI for 10 years almost and have been researching since my injury. I try and help when I can. If I was you, I'd get proper attention pronto, and get busy on lifestyle/dietary changes. I wouldn't commit to any more surgeries until you've committed to at least a month of supplements & nerve flossing etc, unless things get worse, then do what ever you can.

Best of luck!
Christopher

if you want to talk, private message me and we can exchange numbers

have you heard of thoracic outlet syndrome? or has that been mentioned to you? i had some movement restrictions with thoracic outlet symdrome. which the surgery to correct it caused my brachial plexus problems.

thoracic outlet syndrome is where there is not enough room in the shoulder area for all the nerves and blood vessels to run through to the arm properly. causing sometimes severe problems with the arm(s). in my case, i had extra ribs on top that caused the nerve and circulation to be cut off when i raised my arms. when i raised my arms above my chest, they immediately turned white. if i held them over my head for even 5 seconds, they would fall down and within 2 seconds the color and feeling would return.

you might want to google thoracic outlet syndrome and do some research on it. good luck and i hope you find out something SOON.

I dont have TOS. Its stricky burning. Doesnt matter what position my arms are in. The doctor who read the MRN told me I dont have TOS based on my symptoms and how everything else looks structually good.