Diagnosis Explanation:

A brachial plexus injury, commonly called a stinger or burner, occurs when the nerves in the brachial plexus (neck and shoulder region) are stretched or compressed, usually due to a forceful impact, sudden head tilting, or direct trauma. This is common in contact sports (football, wrestling, rugby), falls, or motor vehicle accidents.

Symptoms:

• Sharp, burning pain radiating from the neck to the arm.
• Numbness or tingling in the shoulder, arm, or fingers.
• Temporary weakness in the affected arm.
• Symptoms usually last seconds to minutes but may persist for hours or days in severe cases.

Specific Work Modifications:

• If your job requires standing or walking: Maintain good posture, avoid carrying heavy loads on the injured side, and take breaks to rest the arm.
• If your job involves lifting: Avoid heavy lifting, overhead work, or sudden neck and shoulder movements. Use both hands when possible.
• If your job is desk-based: Adjust your monitor to eye level, use a headset instead of cradling a phone, and take breaks every 30 minutes to stretch.
• Avoid: Overhead reaching, carrying heavy objects, and repetitive shoulder or neck movements.

Specific Activity Modifications:

• If you play sports: Avoid contact sports and impact activities until strength and sensation return fully. Use neck and shoulder padding when returning to play.
• If you do weightlifting: Avoid overhead presses, shrugs, deadlifts, and heavy lifting until symptoms resolve.
• If you do yoga or Pilates: Modify poses to avoid excessive neck extension, deep stretches, or weight-bearing on the injured arm.
• Avoid: Sudden head and neck movements, aggressive stretching, and high-impact activities.

Recommended Supplements:

• Magnesium – 300-400mg daily to relax muscles and support nerve function.
• Vitamin B12 – 1000mcg daily to promote nerve healing.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.
• Collagen Peptides – 10g daily for ligament and nerve support.

Recommended Nutrition and Hydration:

• Eat Anti-Inflammatory Foods (salmon, leafy greens, turmeric, berries, nuts) to support nerve healing.
• Increase Lean Protein (chicken, fish, tofu, eggs) to aid muscle recovery.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tissue elasticity.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to keep nerves and muscles hydrated.

Home Exercise Prescription (Rehabilitation for Brachial Plexus Injury)

Early Phase (0-2 Weeks, Reducing Pain & Nerve Irritation):

• Neck Side Bends – Slowly tilt head to each side, hold 20 seconds, repeat 3x/day.
• Shoulder Blade Squeezes – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
• Nerve Glides (Median Nerve Stretch) – Extend the affected arm out to the side, gently bend and straighten the wrist, 10 reps, 2x/day.
• Upper Trap Stretch – Gently pull head to the opposite side, hold 20 seconds, repeat 3x/day.

Strengthening Phase (2-6 Weeks, Restoring Mobility & Strength):

• Isometric Neck Holds – Press hand against forehead or side of head, resist motion, hold 5 seconds, repeat 10 reps, 2x/day.
• External Rotation (Resistance Band) – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
• Wall Slides – Stand facing a wall, slide arms up slowly, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Enhancing Stability):

• Resistance Band Rows – Pull band toward chest while keeping back straight, 10 reps, 2x/day.
• Scapular Stability Exercises – Maintain good posture while performing controlled shoulder movements, 10 reps, 2x/day.
• Swimming or Light Arm Cycling – 15-20 minutes/day to restore endurance.

Helpful Books:

1. The Nerve Injury Handbook: Strategies for Recovery and Prevention – Andrea Garmendia, MD.
2. Treat Your Own Neck – Robin McKenzie (self-treatment strategies for nerve-related neck pain).

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.