Botox Injections and the Brachial Plexus: A Possible Treatment for Brachial Palsy

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What is Brachial Palsy?

The network of nerves that connects and conducts signals beginning from the spine to the shoulder, arms and hand is called the brachial plexus. Unlike cerebral palsy which is caused by abnormalities in the brain to send signals, brachial palsy is the condition that results from an injury caused by severe damage to the brachial plexus. The brain is functioning normally in terms of sending signals but the nerves cannot deliver them from the shoulders to arms or hand.

Symptoms of brachial palsy are:

  • Lack of muscle control anywhere from the arm, hand or wrist
  • Lack of sensation or feeling in the hand or in the arm
  • Limp arm
  • Paralyzed arm

Causes of Brachial Palsy

For children, injury to the brachial plexus may happen during a difficult birth. If the baby’s shoulder is stretched while passing through the birth canal, damage may result to brachial palsy. Damage to the brachial plexus can also occur as a result of shoulder trauma during contact sports, tumors or inflammation.


For mild cases of brachial plexus injuries, the symptoms usually last for only a few minutes or for a few days. Massaging the area gently and range of motion exercise will give relief and treatment is hardly needed.

For a more severe brachial palsy condition, surgery may be required to repair the injured nerves. Some of the treatment options are:

  • Neurolysis
  • Nerve transfers
  • Nerve grafts
  • Muscle transfers

Brachial Plexus and Botox Injections

The relationship between brachial plexus and Botox injections are being explored by many researchers. Studies are being conducted to determine whether the use of botulinum toxin or Botox injections can aid in the treatment of brachial palsy.

The following is an excerpt from a study carried out by DeMatteo et al. done in 2006:

“Botulinum toxin type A was used to temporarily weaken antagonistic muscles early in the re-innervation process following brachial plexus injury, with the aim of facilitating functional improvement.”

This particular study show that even with surgical repair, the disruption of neural pathways made it difficult for infants to learn specific movement patterns and consequently, full repair and recovery from brachial palsy was not optimized. The botox injection aided in maximizing movement and functions of re-innervated muscles. In another clinical study, botox injections were used to improve elbow flexion. The result of the study showed significant improvement in the participant’s condition after the procedure.

Although this research is still in the initial stages, the results shows promise and positive outcome in treating brachial palsy.


American Society for Surgery of the Hand:

National Institute od Neurological Disorders and Stroke: