Much has been said about the significant physical impairments that a brachial plexus injury (BPI) may cause. Complete return to physical normalcy is often difficult to predict. However, in using modern surgical techniques, considerable function of the affected limb may be restored if nerve reconstruction is done in time.
Though physical recovery from BPI is extremely important, mental health recovery is an often overlooked part of the treatment plan. It is equally important to actively discuss and focus on mental wellbeing following BPI. From the traumatic event causing BPI, to the medical treatment, to the day-to-day life adjustments, to learning how to be ‘you’ again, BPI may cause psychological distress and significant psychosocial stress. Regardless of whether or not one chooses to seek surgical intervention, being attentive to mental health reactions and stress levels is a crucial part of recovery.
Psychological distress following orthopedic trauma is common. BPI can affect a patient as well as their loved ones. Research has shown that for BPI patients, poor mental health and high levels of stress may predict even higher levels of disability. It is not unusual for patients in distress to experience symptoms of post-traumatic stress, depression, anxiety, or in some cases, thoughts of ending their lives. These are common psychological reactions to devastating orthopedic traumas that can be helped with the right mental health treatment. Not everyone develops these symptoms, but approximately a third do.
Some BPI patients may feel self-conscious in public about the appearance of their arm’s musculature or their scars from the accident or the surgery. Well-meant or curious comments from family members, friends, and others may also cause one to feel stressed or under pressure to ‘get better faster’. Careers, financial security, and ability to make a living may also be affected. Adjusting to the physical limits of BPI may lead to significant personal and professional life changes.
Addressing any mental health and stressors related to your BPI will better prepare you for adapting to and accepting life after sustaining a chronic BPI. More and more research shows that better mental health is often linked to improved physical recovery and satisfaction with surgical outcomes. Focusing on your mental health recovery alongside your physical recovery from BPI is vital to restoring positivity, improving outlook, and easing you back into familiar interactions with the people and the activities you love.
Schneider K. Rancy, BA is an office and clinical research assistant at Hospital for Special Surgery. As part of the research team on the Hand and Upper Extremity Service, he conducts research on distal radius fracture fixation, patterns of degenerative and inflammatory arthritis of the wrist, salvage procedures for wrist reconstruction, and long-term motor outcomes following nerve and brachial plexus reconstruction.
Zoe A. Landers, LCSW is a licensed clinical social worker at the Center for Brachial Plexus and Traumatic Nerve Injury (CBPTNI) who evaluates and facilitates treatment for brachial plexus injured patients experiencing psychological and psychosocial stressors following injury. Ms. Landers has actively participated in research with the CBPTNI multidisciplinary team to develop a deeper understanding of the psychosocial and psychological impact of brachial plexus injury. Findings from this research have been presented at major hand and upper extremity orthopedic conferences.