15390 Parsonage Turner Syndrome

Overview

Parsonage Turner syndrome is a rare condition that affects the nerves in your shoulder and arm. It causes sudden, severe pain, followed by weakness and sometimes wasting (shrinking) of the muscles. Another name for it is neuralgic amyotrophy.

No, it is rare. About 1 to 3 people in every 100,000 develop it each year.

It can affect people of any age, but it is most often seen in adults between 20 and 60 years old. It seems to affect men more often than women.

Symptoms

Common symptoms

• Sudden, severe pain in the shoulder or upper arm, often described as a deep ache
• The pain usually goes away after a few days, but then the arm may feel weak
• Difficulty lifting the arm or rotating the shoulder
• A feeling of numbness or tingling in the arm or hand
• Wasting (thinning) of the shoulder muscles after a few weeks

Symptoms in children

• Similar symptoms to adults, but the pain may be harder for a child to describe
• A child may suddenly stop using one arm or hold it close to the body
• Weakness in the shoulder or arm after a viral illness

Symptoms in older adults

• Symptoms may be mistaken for arthritis or a rotator cuff problem
• Weakness and limited movement may be more disabling
• Recovery can take longer, and there is a higher chance of some lasting weakness

Causes

Main causes

• The exact cause is not fully understood
• It is thought to be an autoimmune reaction, where the body's immune system attacks its own nerves
• It often happens after an infection, surgery, or immunisation (vaccination)

Risk factors

• Recent viral infection, like a cold, flu, or chest infection
• Recent vaccination
• Recent surgery or injury
• Physical stress or overwork
• Being male
• Age between 20 and 60
• Having a close family member with the condition (rare)

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe shoulder pain and have lost strength in your arm
• If the pain or weakness is getting worse quickly
• If you have trouble breathing alongside the shoulder pain

Book a routine appointment if:

• If you have shoulder pain that is not going away
• If you notice weakness, numbness, or muscle wasting

Diagnosis

A doctor will take a detailed history and do a physical examination. They will check your muscle strength, reflexes, and sensation. Because Parsonage Turner syndrome can look like other shoulder problems, the doctor may refer you to a neurologist, a specialist in nerves and the brain.

Tests that may be done

• Nerve conduction studies and EMG (electromyography) — tests that check how well your nerves and muscles are working
• MRI scan of the shoulder and neck to rule out other causes like a pinched nerve
• Blood tests to look for signs of inflammation or other conditions

What to expect at your appointment

These tests are usually painless, though the EMG involves small needles inserted into the muscle. They can help confirm the diagnosis and rule out other problems. You may need to wait a few weeks for the full picture of the condition to appear.

Treatment

Treatment focuses on managing pain, helping you keep your muscles moving, and supporting recovery. Many people do not need any specific medical treatment other than pain relief and physiotherapy.

Self-care at home

• Rest your arm during the acute pain phase, but avoid keeping it still for too long
• Use a sling for comfort only if needed, and remove it regularly
• Use warm packs or gentle massage for muscle pain
• Do gentle range-of-motion exercises as advised by your physiotherapist
• Ask your pharmacist about safe pain relief options

Medical treatments

Your doctor or neurologist may prescribe medication to help with nerve pain. Some people are offered a short course of steroid tablets or an injection to reduce inflammation early on. These are given under specialist supervision. Always take medicines exactly as prescribed.

When is surgery considered?

Surgery is rarely needed. It may be considered only if there is severe nerve compression that is not recovering on its own, but this is unusual. Most people are managed with medication and physiotherapy.

Living with this condition

You may need to adapt how you use your arm while you recover. This could mean using your other arm more often, asking for help at home or work, and taking breaks if your arm gets tired.

Lifestyle tips

• Avoid heavy lifting or forceful movements until your doctor or physiotherapist says it is safe
• Do gentle stretching exercises regularly to keep your joints flexible
• Pace yourself – do not try to push through pain
• If you smoke, get support to quit; smoking can affect nerve healing

Diet and exercise

Eat a balanced diet rich in fruit, vegetables, protein, and healthy fats to support nerve repair. Light exercise like walking is usually fine, but avoid activities that strain the shoulder until you have guidance from your healthcare team.

Mental health and emotional wellbeing

Living with a painful, disabling condition can be stressful and affect your mood. It is normal to feel frustrated, anxious, or low. Talk to your doctor if you feel this way, and reach out to trusted friends or family. Some people find talking therapy helpful.

Prevention

There is no known way to prevent Parsonage Turner syndrome, because the triggers are often out of your control, such as an infection or surgery. Keeping a healthy immune system may help, but there is no guarantee.

Vaccines

Some cases have been linked to vaccination, but the risk is extremely small. The benefits of vaccination usually far outweigh the risks. If you have concerns, speak to your healthcare provider.

Screening programmes

There is no routine screening test for this condition.

Complications

If left untreated

• If not recognised and managed, prolonged immobility can lead to a frozen shoulder
• Muscle weakness may last longer, and there is a higher chance of chronic pain
• Some people are left with permanent weakness or muscle wasting

Long-term outlook

Most people improve, but recovery is slow. About 80% of people recover fully or nearly fully within 2 to 3 years. Some may have ongoing pain or weakness. Physiotherapy and good support can make a big difference. It is important to stay patient and positive.

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