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Fast access to private surgery for brachial plexus damage
When the nerves in your brachial plexus become stretched, torn, knotted, or completely separated from your spinal cord (a long, tube-like band of tissue that carries nerve signals from your brain to your body), it can lead to a series of symptoms, such as:
In some cases, brachial plexus injuries can heal on their own, or be treated through physiotherapy. If your problem is severe, and doesn't respond to non-surgical treatment, your consultant may recommend brachial plexus surgery, which should relieve pain and restore full feeling and mobility. There are different surgical treatments available; your consultant will assess your specific condition and decide on the best one for you.
If you would like to know more about brachial plexus surgery, or other treatments for neck or shoulder issues, our experienced consultants are here to help you. Call 0141 300 5009 or book online today and you could have your initial consultation within 48 hours.
This page gives you a complete run-down of what to expect from brachial plexus surgery, including how much it costs, different treatments, and your potential recovery timeline.
Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.
Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over 10 months to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.
If you have private medical insurance, your treatment will usually be covered by your provider. Speak to your insurer directly to find out more information on this.
Most cases of brachial plexus injury occur through a severe blow or stretching movement while performing a physical activity, such as contact sports (football, rugby etc). Your nerves in your brachial plexus may be pulled beyond their limit during a collision or twisting movement with your upper body. This can happen as a result of several kinds of trauma, including vehicle accidents, falls, or gunshot wounds.
The nerves in your brachial plexus are vulnerable during birth, happening in one or two births per 1,000, with larger babies being more at risk. This is because they have an increased chance of their head being stretched away from the shoulder, causing injury to the brachial plexus nerves underneath. Babies born in the breech position (the bottom end comes out first) and/or have a long delivery time are also at risk of experiencing an injury to their brachial plexus.
If you receive radiation treatment for your chest and/or neck, it can cause a tumour (an abnormal mass of tissue that forms when cells grow and divide more than they should) to grow in or along your brachial plexus, or put pressure on the nerves in your brachial plexus.
Also known as neuropraxia, this injury occurs when your nerves are stretched. The nerve root in your brachial plexus (which starts at your neck and goes down to your shoulder) becomes compressed, usually through rotating your head, or is pulled downward. This type of brachial plexus injury is known as a 'burner' or 'stinger' because of its burning and/or stinging sensation.
One of the nerves in your brachial plexus becomes torn, either partially or totally, leading to feelings of weakness in your shoulder, arm, or hand, and can mean that some muscles become non-functional. This injury may also cause severe pain, and generally requires brachial plexus surgery to fix.
A neuroma is a technical term for scar tissue. When your nerve tissue is injured, perhaps during a cut in surgery, scar tissue can form as the nerve tries to repair itself. The result is that one of your brachial plexus nerves becomes knotted and causes pain and/or numbness.
This is a rare kind of brachial plexus injury. Also known as a Parsonage Turner syndrome, brachial neuritis causes sudden and intense shoulder and/or upper arm pain, going rapidly from pain to weakness to muscle loss, and potentially even loss of sensation. The cause of brachial neuritis remains unclear, but it has been suggested that it occurs due to how your immune system handles infections or injury.
An avulsion is when the root of one of the nerves in your brachial plexus becomes completely separated from your spinal cord. This usually happens as a result of trauma, such as a sports injury or vehicle accident, causing you severe pain. Reattaching the root to your spinal cord is usually impossible, so you might have permanent weakness and loss of feeling as a result.
The first step will be taking a detailed history of your symptoms, such as how and when the injury occurred and to what extent they impact your daily activities, along with taking a note of your general health. Learning about weakness, paralysis, or the nature of your pain (stinging, stabbing, dull, etc) can help them find out the location and severity of your brachial plexus injury.
Your consultant may perform a physical examination, which involves comparing motor function, sensation, and pain in your affected limb, in contrast with your unaffected side. They will do this by asking you to do certain movements with your arms and note where and when you feel pain and/or numbness.
To gain a clear understanding of your injury and the kind of brachial plexus surgery best suited to you, your consultant may do a series of imaging tests, which can involve:
During an electromyography test (EMG), your consultant inserts a small needle into various muscles, allowing them to assess the electrical activity of your muscles when they contract and then rest. If the electrical activity is different to normal, it helps them know where you may have a damaged nerve. This is usually carried out alongside nerve conduction studies, which measure the speed of conduction in your nerve and shows your consultant how well your nerve is functioning.
This test uses powerful magnetic field and radio waves to produce detailed images of the soft tissues (tendons, ligaments, muscles, cartilage) and the status of the arteries that are important for the functioning of your arm.
This scan uses a series of complex X-rays that capture images of your body and generate detailed pictures of your spinal cord and nerve roots, allowing them to see whether there has been any damage to the nerves in your brachial plexus.
In cases where your brachial plexus injury is severe, on the other hand, your consultant may recommend surgery. They will speak to you about how you can prepare for the procedure beforehand.
After your brachial plexus surgery, you may need to stay in hospital for a night, as this gives us time to give you pain relief and monitor how you've recovered from the procedure. So be sure to bring anything that might make your stay with us more comfortable, such as loose-fitting clothing or a laptop to keep you entertained.
For the first few weeks following your procedure, the movement of your arm will be severely limited, so making quick trips to the shops won't be possible. Ahead of coming to hospital, then, make sure you have everything you need at home and within easy reach. If possible, have a friend or relative nearby who can assist you with daily activities.
Take care to remove anything in your home that might cause you to trip and lead to further damage to your shoulder and arm, such as loose flooring, general mess, or furniture.
If you're taking warfarin, aspirin, anti-inflammatory medications, or any other medications that are blood thinners, your consultant may ask you to stop taking these two weeks before your brachial plexus surgery to ensure against unwanted bleeding during and after your surgery.
Smokers need more general anaesthetic during surgery, which can cause breathing problems. You may also be more at risk of having heart issues if you smoke, and your overall recovery may be affected if you keep smoking after your surgery. As a result, we always recommend that you stop smoking at least one week beforehand.
Like before any operation involving general anaesthetic, don't eat or drink anything after midnight on the day of your procedure, and avoid alcohol for 48 hours prior to visiting hospital.
If your nerve has been torn, your surgeon may be able to reconnect it by sewing the ends of some nerves back together. On the other hand, if your nerve has been compressed but remains intact, your surgeon may perform neurolysis - a decompression surgery that removes scar tissue from around the affected nerve, which in turn relieves pressure on this area.
In cases where your nerve has been injured or badly scarred, your surgeon may choose to perform a nerve graft surgery. This involves removing the damaged nerve segment and replacing it with a piece of an expendable sensory nerve from another part of your body. Doing this creates a channel that replaces the injured part of your nerve and allows for a pathway for nerve regeneration.
This procedure is performed when your nerve root has been torn from your spinal cord. Your surgeon will take a nerve from nearby that isn't critical (from under your ribs, or perhaps a nerve in your hand) and connect it to the nerve that is no longer working, creating a foundation for new nerve growth in this area.
This form of brachial plexus surgery is usually only chosen when too much time has passed after your injury, meaning repair or nerve grafting and/or transfer isn't an option. During this procedure, your gracilis muscle in your inner thigh (a long, thin muscle in the middle of your thigh that is nonessential) will be carefully removed and transplanted to replace a non-functioning muscle in your shoulder, upper arm, or hand, with your surgeon connecting tiny blood vessels under a microscope to restore blood flow.
When you wake up after brachial plexus surgery, you may feel quite groggy, but this is normal as your general anaesthetic wears off. You will be transferred to a private post-operative room and given time to rest, with pain relief provided by your nurse. Usually, we require you to stay the night at hospital to check on how you've responded to surgery and provide information about aftercare and physiotherapy, which is a crucial aspect of recovery from brachial plexus surgery.
Your arm will be placed in a protective dressing and a splint or sling. How long you'll need to wear this for depends on the type of brachial plexus surgery you received.
You will need to rest your arm, keeping it in an elevated position to enable faster healing, and take care to avoid any rapid twisting movements in the early stages of your recovery. You shouldn't feel much discomfort after brachial plexus surgery. If you do, take painkillers whenever needed.
If you had a nerve repair, transfer, or graft, you may only need to wear a sling or splint for around two weeks. For muscle or tendon transfer, on the other hand, it could be required for one to three months.
When you can return to work depends on the nature of your job. If you have a sedentary role (one that doesn't require manual tasks, such as a desk job), you should be able to resume light activities at work after two weeks. If your job does require manual exertion, recovery will take longer. Please speak to your consultant about an appropriate time to return to tasks such as heavy lifting. It is possible that you will have a less functional arm and/or hand after brachial plexus surgery, which may mean you have to make adjustments in terms of employment and daily activities.
Once your sling or splint has been removed and you don't have any pain and mobility in your arm, you should be able to return to driving. Getting to this stage typically takes two to four weeks. A follow up with your consultant shall be arranged for three weeks after surgery to check on how your wound has healed.
After your sling or splint has been removed and you return to normal activities, you will need to see your consultant for regular check-ups and to manage your pain every three months. This is particularly important for babies, and could be required for up to two years.
During this time, your physiotherapist will provide you with a programme of physical exercises designed to prevent muscle atrophy and contractures (a fixed tightening of muscle, tendons, ligaments, or skin), as well as promote nerve regeneration, which is key for improving movement and sensation. The exact type of therapy and how long you need to do it for will depend on what brachial plexus surgery you received. In some cases, physiotherapy may need to last for up to two years.
Complications can occur with brachial plexus surgery, but these are rare. All risks will be explained to you by your consultant ahead of your surgery and you'll be given the chance to ask them any questions.
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Content reviewed by Circle in-house team in December 2022. Next review due December 2025.