Brachial Neuritis

What is it?
The brachial plexus is the web of nerves that exit the neck and provides power to the muscles of the entire shoulder girdle and upper extremity. Part of or all of the plexus can become inflammed, but the cause is not known. It is associated with heavy exercise in some patients, so can be seen in throwers.

What does this feel like?
This can caus a dull aching pain to a sharp lancinating or shooting pain around the shoulder and down the arm for a few weeks to months, then gradual loss of strength which makes throwing very difficult. Total paralysis in some of the muscles of the shoulder or arm can occur, but loss of feeling or sensation is minimal and not complete.

How is it treated?
Nonoperative treatment is usually successful, but can take 9-12 months, and full recovery might not occur for up to 3 years. Rest does help, so time off throwing is recommended. Therapy is prescribed. At first, therapy is to maintain motion. Then exercises progress to strengthen muscles, and finally to rehabilitate throwing-specific muscles with an interval throwing program.

Operative treatment is rarely indicated for this problem as recovery is normally quite good. If recovery is very poor, tendon or nerve transfers may be needed but that is extremely uncommon.

How long will I be out of throwing?
It is usually 1-3 years for complete recovery but the athlete may throw when able, which sometimes occurs as soon as the next season. About 5-10% of patients do have permanent partial weakness.