Brachial radiculitis is a certain type of peripheral neuropathy related to brachial plexus that severely affects the chest, shoulder, arm and hand. In peripheral neuropathy, the nerves that carry signals to and from the brain, spinal cord, and certain part of the body are ruptured due to any physical reasons. Brachial radiculitis is also called brachial plexus injury. Brachial plexus is a bundle of nerves that links spinal cord with the chest, shoulder, arms and hands. In this rare condition, damage to the brachial plexus occurs all of a sudden, and on many occasions, it may occur without any apparent physical damage to that part of the body. Brachial radiculitis normally affects the lower nerves of the brachial plexus that links one or both sides of the chest, and both shoulders, arms, and hands with the spinal cord.
Types of Brachial Radiculitis
There are two types of brachial radiculitis and they are:
- Acute Brachial Neuritis: This type of brachial radiculitis takes place suddenly without any apparent reason. It brings sudden and severe pain in the brachial plexus nerves. With the onset of such pain, the patient may also feel numbness in the affected part of the arm and shoulder.
- Brachial Plexus Injury: It occurs due to any sudden accident or pressure due to any other reasons, tumor in the shoulder, trauma, knife laceration, as well as excess pressure experienced by the baby while passing through the birth canal, etc.
Causes of Brachial Radiculitis
The actual cause of brachial radiculitis is unknown to the researchers. However, in case of trauma, the concerned nerves may be injured leading to brachial radiculitis. In other instances, why does it occur without any visible reason, or why does it occur due to other illnesses, is still unknown to the medical fraternity.
Symptoms of Brachial Radiculitis
Following are the symptoms of brachial radiculitis:
- Pain in the upper arm and shoulder are common symptoms of brachial radiculitis. Sometimes, either in the upper arm or in the shoulder the pain may be felt. Pain intensifies at night.
- In majority of cases of brachial radiculitis, pain occurs only in one side of the body, especially in the right part of the body. In 10-30% of cases, both part of the body may be affected.
- Affected shoulder or arm may lose feeling or sensation. Lack of sensation or feeling in the shoulder or arm is also a symptom of brachial radiculitis.
- As the day pass, if treatment is not started, weakness and tenderness in the muscles may occur.
- On many occasions, arm and shoulder muscles become uncontrollable.
- In some extreme conditions, the affected side of the body may be partially paralyzed.
- Symptoms may resolve slowly over a few weeks' time, but it may relapse once again.
Treatment for Brachial Radiculitis
In most of the cases of brachial radiculitis, particularly if the symptoms are detected at an early stage, neurologists generally opt for conservative treatment procedures. Pain relievers are given if the brachial radiculitis pain is not severe, whereas, in case of intense pain, chronic narcotic therapy may be required. Besides, the following steps are also adopted depending on the situations:
- The brachial radiculitis patient is asked to take maximum rest, but much dependency on a sling for support is not good in brachial radiculitis.
- A high-dose of corticosteroid may be given to treat brachial radiculitis.
- Neurotropic medications are given that can stabilize the nerve membranes, and can also manage the pain.
- If the brachial radiculitis pain still persists longer than 2 years, doctors may advise for a nerve grafting or tendon transfer surgery.
- If the problem of brachial radiculitis pain has developed during any exercise, practice session, or competition, neurologists ask to completely stop exercising or performing for some time.
- Some physical therapy is also needed after the severity of the pain has subsided.
Rehabilitation in Brachial Radiculitis
In treating and recovering from brachial radiculitis, physical therapy has a significant part to play. An expert physiotherapist provides support at the initial stages; he or she may also teach the family members the different processes and cautions to be adopted while performing these exercises. The goals of rehabilitation in brachial radiculitis are as follows:
- Pain could be managed significantly
- Movement of the affected body parts will also be eased
- Shoulder and the elbow will get back its strength.
Prognosis and Recovery Period of Brachial Radiculitis
Patients regain their strength and the brachial radiculitis pain is normally relieved in 80% of cases within 2 years, and more than 90% cases within 3 years. Recovery from brachial radiculitis takes place at a slower rate than any other kinds of similar issues. Within 3-4 months' duration, muscle weakness and decreased sensation associated with brachial radiculitis is reduced in 80-90% of the cases. The recurrent cases are minimum having a range in between 5-20%. Also a minimum number of brachial radiculitis patients require surgical intervention.
Diagnosis of Brachial Radiculitis
The affected person with non-traumatic brachial radiculitis generally reports the unexpected beginning of severe pain in the shoulder, arm and neck. At the same time, numbness and weakness is also experienced. People often mistake it with some other problems like sudden twist in the neck and muscle. For fixing the actual problem, and examining whether it is a case of brachial radiculitis, following examinations are conducted:
- The doctor will go for some physical examination at first. Muscle pain, weakness in the arm, and paralysis are detected through physical checkup of the body parts. The arm muscles may perform poorly while physical testing. These may show much decreased reflexes, and the patient may not have any or reduced feeling in the shoulder and arm.
- Some pathological tests like CBC (Complete Blood Count), ANA (Antinuclear Antibodies), Erythrocyte Sedimentation Rate (ESR), and X-ray may be conducted to eliminate the possibility of other diseases. This is called differential diagnosis process. In some cases, patients are also tested for HIV.
- For more confirmation, MRI, CT Scan, and Needle EMG (Electromyography) may be conducted. MRI and CT scan are again used as differential diagnosis methods, and Needle EMG is conducted to ensure the existence and extent of brachial radiculitis.
Brachial radiculitis is not a common disease. The actual cause of brachial radiculitis is yet to be discovered, but trauma and accidental damage to the brachial plexus nerves are the most obvious reasons behind brachial radiculitis. Neurologists often need to go for a differential diagnosis process for detecting the disease and take necessary measures. Physical therapy plays a significant role in treating brachial radiculitis; however, doctors may prescribe relevant drugs to manage severe pain, and weakness of the affected parts. In most of the cases, brachial radiculitis patients recover from the symptoms within 2 years, but in some exceptional cases surgeries may be needed.