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Nonsurgical Treatment for Brachial Plexus Injuries

NYU Langone doctors determine the most effective treatment plan for brachial plexus injuries based on the type of injury and the severity of symptoms. Your doctor may ask that you come in for several visits over the course of three to six months so that they can assess how your injury is healing and adjust your treatment plan if needed.

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Our doctors may recommend a combination of treatments to relieve pain, stabilize the injured area, and improve your range of motion and strength. These can include medications to reduce pain and stabilizing devices, such as casts and splints, to preserve and improve motion. For most people with brachial plexus injuries, physical and occupational therapy are key components of both treatment and recovery.

Pain Relief Medication

Brachial plexus injuries can limit your range of motion and cause pain in your neck, shoulder, arm, wrist, or hand. Your doctor may recommend an over-the-counter pain medication for relief, such as acetaminophen or ibuprofen. If necessary, a stronger pain medication may be prescribed for one or two weeks.

Casts and Splints

Our doctors may recommend using a series of custom casts to treat the brachial plexus injury and improve range of motion and joint alignment by gradually stretching the joint. During this process, a new cast is applied weekly for up to six weeks to the injured area. Your doctor monitors your recovery and performs imaging tests to assess whether the injury is healing. When there is improvement, the cast can be removed, allowing for the injured area to bend and move.  

Our orthotics specialists may use a custom splint instead of a cast to immobilize the affected area, especially for children. This can help prevent soft tissue contractures—a shortening of the muscle that restricts movement—from developing. A custom splint conforms to the shape of your arm, and is held in place by straps. The splint is used to support the injured area and hold it in a specific position. Your doctor determines the appropriate length of time for you to wear the device.

Physical and Occupational Therapy

Once you can move comfortably, our orthopedic experts may recommend physical therapy to build strength lost from a brachial plexus injury. Our physical therapists at Rusk Rehabilitation develop a comprehensive plan to promote healing that includes a combination of movement and additional therapies.

Your physical therapist designs a program that may include resistance bands, free weights, aquatic therapy, and rehabilitation equipment such as the upper body ergometer or arm bike. Your therapist may also recommend an at-home routine of basic stretching and strengthening movements to perform in between sessions, and following completion of therapy.

Our physical therapists can perform transcutaneous electrical nerve stimulation (TENS) to help relieve pain. Your therapist attaches electrodes to the injured area that painlessly deliver low-voltage electrical impulses that travel along nerve fibers. Your therapist may also apply a stretchy, waterproof therapeutic tape to the injured area to support the muscles and stimulate blood circulation.

Occupational therapy may be recommended if your fine motor skills have been affected. Our occupational therapists at Rusk Rehabilitation design a specialized plan with therapeutic exercises to help you complete everyday tasks such as bathing, dressing, and driving. Our therapists are trained experts with advanced certification in treating complex injuries such as brachial plexus injuries.

Our Research and Education in Brachial Plexus Injuries

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