Pain Interference in Young Adults With Brachial Plexus Birth Injuries

Clinical management for brachial plexus birth injuries (BPBI) is often focused on childhood, leaving a gap in understanding of how this condition impacts individuals into young adulthood. Recent studies suggest that pain persists beyond pediatric care, although the long-term trajectory of pain and function remains poorly understood. This study compares pain interference in young adults with BPBI to matched controls. Secondary objectives were to compare pain intensity between groups, examine the relationship between upper limb function and pain, and identify common areas of pain using self-reported body maps.

A cross-sectional study was performed comparing 26 young adults with BPBI and 26 healthy controls, matched by age and sex. Participants completed the Brief Pain Inventory and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire online. Mann-Whitney U tests, Spearman correlations, and Fisher's exact tests were used to analyze group differences and associations.

Compared with controls, BPBI participants (n = 21, 81%) reported pain beyond everyday types of pain and had significantly higher pain interference and upper limb activity limitation (P < .001). Pain interference was strongly positively correlated with activity limitation. Prevalence of ipsilateral truncal and upper-extremity pain was significantly higher than in the same regions on the unaffected side (P ≤ .004). However, the unaffected posterior neck, shoulder joint, upper and lower back, hand, and wrist demonstrated elevated reports of pain.

Young adults with BPBI experience widespread pain that interferes with daily life, which is greater than previously recognized. Pain screening, including potential overuse of the unaffected side, are recommended.

Cross-sectional study with cases and controls; Level IV.