Brachial plexus neuropathy (BPN) occurs when nerves in your upper
shoulder area become damaged and cause severe pain in your shoulders or arms.
BPN may also limit movement and cause decreased sensation in these areas.
The pain associated with BPN generally occurs suddenly and may be
followed by weakness in a specific muscle of the arm or shoulder. BPN is an
uncommon condition, and its presentation may be misleading. It can sometimes be
misdiagnosed as cervical disc herniation.
Causes of BPN
BPN is a type of peripheral neuropathy, which refers to damage to
a single nerve or a set of nerves. If you have BPN, it’s the brachial plexus that’s
damaged. This is an area where nerves from the spinal cord branch into the arm
nerves. The nerves of the brachial plexus run from your lower neck through your
Damage to the brachial plexus usually results from direct injury.
Other common causes of damage to the brachial plexus include:
- birth trauma
- injury from stretching
- pressure from tumors
- damage from radiation therapy
Brachial plexus neuropathy may also be associated with:
- birth defects
- exposure to toxins
- inflammatory conditions
- immune system issues
There are also numerous cases in which no direct cause can be
BPN Risk Factors
There are no specific risk factors associated with BPN. However,
young men are more likely than women and older men to develop a rare brachial
plexus condition known as Parsonage-Turner
syndrome, which can cause shoulder paralysis.
Symptoms of BPN
BPN can cause numbness in your shoulder, arm, and hand. Severe
cases can cause a complete loss of sensation. This numbness can cause
additional complications related to recurring injury to the affected areas. You
won’t notice these complications if you have an inability to detect pain in
Sometimes BPN can cause abnormal sensations such as tingling and
burning on or near nerves related to the brachial plexus. These types of
sensations generally occur in your arm and hand.
A decreased ability to lift your wrist or extend it backward is a
common way for BPN to manifest. Weakness in your hands may also indicate you
Horner syndrome is rare, but it can indicate BPN. Horner’s
syndrome is caused by an interruption in the nerve signals that control parts
of the face. It’s usually caused by an injury to the nerves of the brachial
plexus. The symptoms of Horner’s syndrome are:
- constriction of the pupil, which makes it become
- eyelid drooping
- an inability to sweat in the affected area of
Your doctor will examine the following to diagnose nerve issues
involving the brachial plexus:
Some signs of nerve issues may include:
- arm deformities
- hand deformities
- diminished reflexes in the arm
- muscle wasting, or loss of muscle strength
- muscle wasting or atrophy (decreased muscle size
- an inability to flex the hand and wrist
- difficulty in moving the arm, shoulder, hand,
Your doctor will ask you for a detailed medical history to find the
cause of your BPN.
They may order certain tests to diagnose the condition. These can
- blood tests
- chest X-rays
- an electromyogram, which is done to test the
function of muscles and related nerves
- an MRI of the head, shoulder, or neck
- a nerve biopsy, which involves removing a piece
of nerve for analysis
- nerve conduction tests, which are done to
determine how impulses are traveling through a nerve
BPN treatment is focused on correcting any underlying causes and
allowing for optimum range of motion. In many cases, no treatment is needed due
to spontaneous recovery.
Taking over-the-counter medications generally controls the pain.
Your doctor may also prescribe:
- tricyclic antidepressants
- other medications
Your doctor might recommend physical therapy to maintain or
increases your muscle strength. Orthopedic assistance may also increase range
of motion. This type of therapy usually involves using braces, splints, or
other similar aids.
You may need surgery if nerve compression is causing your
symptoms. Underlying medical conditions such as diabetes and kidney disease may
also need to be treated as these diseases can adversely affect nerves.
BPN and the Workplace
Sometimes the injury that causes BPN happens while you’re at work.
To get back to work and prevent further nerve damage, your doctor may
- vocational counseling
- occupational therapy
- vocational changes
Your outcome largely depends on the cause of your BPN. Recovery
is more likely if the cause of your BPN is identified and treated properly.
People with BPN can sometimes have partial or complete loss of
sensation, and their range of motion can also be permanently limited. Nerve
pain can be severe and last for a long time. Working with your doctor will help
ensure you get the proper treatment.
Prevention methods vary depending on the cause of your BPN. Once
you’ve been diagnosed with BPN and your doctor determines the cause, they can
provide you with prevention methods.