Parsonage-Turner Syndrome may sound a little like a band from the 1970s but, in fact, this medical condition could be the cause of your ongoing neck and shoulder pain. Also known as brachial neuritis, this syndrome involves inflammation of the brachial plexus that results in acute pain in the shoulder and arm, sometime radiating into the neck and leading to weakness and/or numbness.
Causes of Brachial Neuritis
Nerves that exit the cervical spine come together in the brachial plexus, an area running across the shoulder and down into the arm. Brachial plexus injuries are common in football players, and even in children who had a difficult birth where their shoulder became stuck. Microtrauma in this area can also lead to brachial neuritis, with sudden onset of severe pain. In some cases, however, there is no clear cause of brachial neuritis.
Symptoms of Brachial Neuritis
This condition may also be referred to as brachial plexitis, radiculitis, brachial plexopathy, and Parsonage-Aldren-Turner syndrome. It is still relatively rare but can be severely debilitating as the pain is acute, sharp, and severe, usually unilateral (i.e. in one shoulder or arm or side of the body), and may lead to significant weakness in the arm and shoulder.
Typically, the pain persists over several days and a number of muscles may become weak. However, it usually resolves within a few months or a year and few people experience ongoing paralysis.
Diagnosing Brachial Plexopathy
This condition is difficult to diagnose because no clear signs are visible on imaging in most cases. Patients may undergo x-ray, MRI scan, and EMG studies to ascertain if this is a brachial plexus issue or connected to the cervical spinal nerve roots. Brachial neuritis is usually the diagnosis if pain is severe but brief (i.e. lasting under ten days). It is also typically accompanied by severe weakness.
Similar symptoms may arise due to a herniated disc in the neck, arthritis changes in the cervical spine, or even a spinal tumor pressing on cervical nerves. If these mechanical issues are indicated then surgery may be necessary, but care must be taken to conduct an electromyelogram to confirm the condition in order to avoid surgery which is unnecessary.
Treating Brachial Plexopathy
Brachial neuritis is usually managed with oral steroids to lower inflammation, rest and reduced activity, narcotic pain medications, and nerve stabilizing medications like Lyrica or Neurontin to protect nerve membranes and reduce neck and shoulder pain. Patients may also practice other types of pain management while undergoing physical therapy and simply giving themselves time to heal from brachial plexus injury.