Stories about: brachial plexus avulsion injury

Questioning “wait and see” in motor nerve injuries

Untreated carpal tunnel syndrome causing atrophy of the muscles of the thumb (Harry Gouvas/Wikimedia Commons)

It’s common in medicine for physicians to “wait and see” before taking treatment to a more invasive (or expensive) level. But when it comes to motor nerve injuries, combined laboratory and clinical evidence suggests that approach may be fundamentally wrong.

That would go for injuries including carpal tunnel syndrome, cubital tunnel syndrome (a compression injury of the ulnar nerve in the elbow), nerve damage from surgery or chemotherapy, and brachial plexus avulsion injuries (these often happen when people fall off their bikes; the arm is bent backwards and nerves get ripped out of the spinal cord).

In serious cases, patients may recover sensory function, but rarely recover full muscle function and strength. Lab studies by neuroscientists at Children’s Hospital Boston provide a biological explanation, and therein may lie a solution.

It’s not that injured motor nerve fibers don’t regrow – they can. It’s that they don’t grow fast enough.

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