Brachial Plexus Injury in Sports Medicine Medication
- Author: Thomas H Trojian, MD; Chief Editor: Sherwin SW Ho, MD more...
The goals of pharmacotherapy are to reduce morbidity and prevent complications. Drugs containing opiates, such as codeine, are typically used immediately following the injury. Antidepressant and anticonvulsant medications may also be useful. A device called transcutaneous electrical nerve stimulation (TENS) sometimes provides relief in conjunction with pharmacotherapy.
Analgesia is important to obtain in the setting of brachial plexus nerve injuries. This can be accomplished by use of anti-inflammatory and/or opiate-narcotic medications. Analgesia may facilitate further assessment of the athlete, as well as their willingness to participate in therapy sessions.
Drug combination indicated for moderate to severe pain.
Drug combination indicated for short-term (less than 10 d) relief of moderate to severe acute pain
Drug combination indicated for the relief of moderate to severe pain.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Have analgesic and antiinflammatory activities. Their mechanism of action is not known, but they may inhibit cyclo-oxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell-membrane functions.
DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
For relief of mild to moderate pain and inflammation. Small dosages initially are indicated in small and elderly patients and in those with renal or liver disease. Doses over 75 mg do not increase therapeutic effects. Administer high doses with caution and closely observe patient for response.
For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing activity of cyclo-oxygenase, which results in a decrease of prostaglandin synthesis.
Charbonneau RM, McVeigh SA, Thompson K. Brachial neuropraxia in Canadian Atlantic University sport football players: what is the incidence of "stingers"?. Clin J Sport Med. 2012 Nov. 22(6):472-7. [Medline].
Starr HM Jr, Anderson B, Courson R, Seiler JG. Brachial plexus injury: a descriptive study of American football. J Surg Orthop Adv. 2014 Summer. 23(2):90-7. [Medline].
Chao S, Pacella MJ, Torg JS. The pathomechanics, pathophysiology and prevention of cervical spinal cord and brachial plexus injuries in athletics. Sports Med. 2010. 40(1):59-75. [Medline].
Terzis JK, Kokkalis ZT. Selective contralateral c7 transfer in posttraumatic brachial plexus injuries: a report of 56 cases. Plast Reconstr Surg. 2009 Mar. 123(3):927-38. [Medline].
Bengtson KA, Spinner RJ, Bishop AT, Kaufman KR, Coleman-Wood K, Kircher MF, et al. Measuring outcomes in adult brachial plexus reconstruction. Hand Clin. 2008 Nov. 24(4):401-15, vi. [Medline].
Colbert SH, Mackinnon SE. Nerve transfers for brachial plexus reconstruction. Hand Clin. 2008 Nov. 24(4):341-61, v. [Medline].
Amrami KK, Port JD. Imaging the brachial plexus. Hand Clin. 2005 Feb. 21(1):25-37. [Medline].
Bertelli JA, Ghizoni MF, Loure Iro Chaves DP. Sensory disturbances and pain complaints after brachial plexus root injury: a prospective study involving 150 adult patients. Microsurgery. 2011 Feb. 31(2):93-7. [Medline].
Sulaiman OA, Kim DD, Burkett C, Kline DG. Nerve transfer surgery for adult brachial plexus injury: a 10-year experience at Louisiana State University. Neurosurgery. 2009 Oct. 65(4 Suppl):55-62. [Medline].
Terzis JK, Barmpitsioti A. Wrist fusion in posttraumatic brachial plexus palsy. Plast Reconstr Surg. 2009 Dec. 124(6):2027-39. [Medline].
Clancy WG Jr, Brand RL, Bergfield JA. Upper trunk brachial plexus injuries in contact sports. Am J Sports Med. 1977 Sep-Oct. 5(5):209-16. [Medline].
Sallis RE, Jones K, Knopp W. Burners. Offensive strategy for an underreported injury. Phys Sports Med. 20(11):47-55.
Meeuwisse WH, Hagel BE, Mohtadi NG, Butterwick DJ, Fick GH. The distribution of injuries in men's Canada West university football. A 5-year analysis. Am J Sports Med. 2000 Jul-Aug. 28(4):516-23. [Medline].
Padua L, Di Pasquale A, Liotta G, Granata G, Pazzaglia C, Erra C, et al. Ultrasound as a useful tool in the diagnosis and management of traumatic nerve lesions. Clin Neurophysiol. 2013 Jun. 124(6):1237-43. [Medline].
Zhu YS, Mu NN, Zheng MJ, Zhang YC, Feng H, Cong R, et al. High-resolution ultrasonography for the diagnosis of brachial plexus root lesions. Ultrasound Med Biol. 2014 Jul. 40(7):1420-6. [Medline].
Lapegue F, Faruch-Bilfeld M, Demondion X, Apredoaei C, Bayol MA, Artico H, et al. Ultrasonography of the brachial plexus, normal appearance and practical applications. Diagn Interv Imaging. 2014 Mar. 95(3):259-75. [Medline].
Cramer CR. A Reconditioning Program to Lower the Recurrence Rate of Brachial Plexus Neurapraxia in Collegiate Football Players. J Athl Train. 1999 10. 34(4):390-396.
Dorsi MJ, Hsu W, Belzberg AJ. Epidemiology of brachial plexus injury in the pediatric multitrauma population in the United States. J Neurosurg Pediatr. 2010 Jun. 5(6):573-7. [Medline].
Kuhlman GS, McKeag DB. The "burner": a common nerve injury in contact sports. Am Fam Physician. 1999 Nov 1. 60(7):2035-40, 2042. [Medline].
Levitz CL, Reilly PJ, Torg JS. The pathomechanics of chronic, recurrent cervical nerve root neurapraxia. The chronic burner syndrome. Am J Sports Med. 1997 Jan-Feb. 25(1):73-6. [Medline].
Markey KL, Di Benedetto M, Curl WW. Upper trunk brachial plexopathy. The stinger syndrome. Am J Sports Med. 1993 Sep-Oct. 21(5):650-5. [Medline].
Stracciolini A. Cervical burners in the athlete. Pediatr Case Rev. 2003 Oct. 3(4):181-8.
Weinberg J, Rokito S, Silber JS. Etiology, treatment, and prevention of athletic "stingers". Clin Sports Med. 2003 Jul. 22(3):493-500, viii.
Weinstein SM. Assessment and rehabilitation of the athlete with a "stinger". A model for the management of noncatastrophic athletic cervical spine injury. Clin Sports Med. 1998 Jan. 17(1):127-35. [Medline].
Williams J, Hoeper E. Brachial plexus injury in a male football player. Curr Sports Med Rep. 2004 Jun. 3(3):125-7.