Brachial plexus lesions as a consequence of carrying a heavy backpack have been reported, but the typical clinical course and long-term consequences are not clear. Here we evaluated the clinical course and pattern of recovery of backpack palsy (BPP) in a large series of patients.
Eighty percent of the patients recovered totally within 9 months after the onset of weakness. Prolonged symptoms occurred in 15% of the patients, but daily activities were not affected. The weight of the carried load at the symptom onset significantly affected the severity of the muscle strength loss in the physiotherapeutic testing at the follow-up. The initial electromyography did not predict recovery. Genetic testing did not reveal de novo hereditary neuropathy with pressure palsies.
Conclusions: The prognosis of BPP is favorable in the vast majority of cases. Electromyography is useful for diagnosis. To prevent brachial plexus lesions, backpack loads greater than 40 kg should be avoided.
What is a Brachial Plexus injury ?
A brachial plexus injury is an injury to the the network of nerves that sends signals from your spine to your shoulder, arm and hand. A brachial plexus injury occurs when these nerves are stretched or, in the most serious cases, torn. This happens as result of your shoulder being pressed down forcefully while your head is pushed up and away from that shoulder.
Brachial Plexus injuries arise from: contact sports, poor posture, heavy backpack use (above), Whiplash injuries arising from auto or motorcycle accidents, infants can acquire this condition during birth and other rare occurrences such as tumors.
Most Brachial Plexus lesions are treated conservatively (with therapy and/or rest) but severe lesions require surgical intervention.
Neck pain, burning, numbness/tingling and/or weakness into one or both arms.
One of the most common forms of Brachial Plexus lesions is a condition called Thoracic Outlet Syndrome which will be discussed in a separate post.