What is it?

Parsonage Turner syndrome is a neurological disorder that causes sudden and severe pain in your upper arm and shoulder. Weakness in the muscles of the shoulder, arm, forearm or hand follow the pain, which lasts from days to a few weeks.

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Additional names

This group contains additional names:
- Parsonage Turner syndrome

Signs & symptoms

Because people are different, the severity of pain, location of pain and/or duration of pain and weakness won’t be the same. Symptoms of Parsonage Turner syndrome may include:
* Sudden sharp, aching, burning or stabbing pain (gradual in rare cases).
* Pain in one shoulder (rarely in both shoulders). Possible pain also in the neck, arm and hand (on the same side as the painful shoulder). Pain in the legs (rare).
* Pain is worse during the evening or during the night. Pain may be mild or unbearable and incapacitating.
* Muscle weakness in the shoulder (days or weeks after the initial pain). The weakness can be mild, severe, or almost paralyzing (this is rare).
* Problems with reflexes.
* Loss of sensation or numbness. Feeling tickling, prickling, or burning.
* Partial dislocation of the shoulder joint. Abnormal range of movement of joints. Winged scapula (a condition where the shoulder blade sticks out).
* Shortening of the muscles or tendons.
* Shortness of breath (rare). Excessive sweating.
* Red, purple, or spotted hands. Swelling.

Diagnosis

Your doctor will note your symptoms. He or she will test for muscle strength, reflexes and feeling in your arm. If your healthcare provider thinks you have Parsonage Turner syndrome, he or she may want you to have a test called an electromyography (EMG). This test consists of two parts:
* In the first part, nerves are shocked in a controlled fashion and responses are measured.
* In the second part, tiny needles are inserted in various muscles of the arm to study the electrical activity of those muscles at rest and with movement. The EMG can help determine the location, nature and severity of nerve damage. The EMG test takes one to two hours. It may hurt a little bit as the needles are put in. You may get sore and your arm may tingle for a few hours after the test.
You might also have an MRI scan, nerve ultrasound and/or CT scans to confirm the diagnosis, or rule out other conditions.

Treatment

Experts have yet to find a specific treatment for Parsonage Turner syndrome. Some treatments that may work for you include:
* Using painkillers to manage the pain. The pain is worse when the problem first starts. Medications such as tricyclic antidepressants, duloxetine or gabapentin may also be used for pain. Steroid medications such as prednisone may be considered in the early phase. The pain lessens as the months pass.
* Your doctor may suggest you do physical and occupational therapy for three to eight weeks. This can help with your range of motion and help keep your strength up.
* TENS (transcutaneous electrical nerve stimulation) may help with the pain by changing or blocking nerve transmissions.

Surgery is considered only after other treatments fail. You might have a nerve grafting or tendon transfer. A nerve graft is where the surgeon takes a bit of nerve tissue from another part of your body and uses it to repair damaged nerves. Similarly, a tendon transfer is where a healthy tendon is removed from another part of your body to replace a damaged tendon in, for example, your shoulder.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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