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Parsonage-Turner Syndrome: What You Need to Know

Medically Reviewed by Michael W. Smith, MD on October 14, 2021

Parsonage-Turner syndrome (PTS) is a condition that brings on sudden, severe pain in your shoulder and upper arm, and then longer-lasting muscle weakness. It usually affects one side of your body.

It’s a neurological disorder, which means it affects your nervous system. You might also hear your doctor call PTS by other names, like “brachial neuritis” or “neurologic amyotrophy.”

PTS involves damage to a network of nerves called the brachial plexus. This controls movement and feeling in your shoulders and arms, with nerves running from your spine through your neck, into both of your armpits, and down your arms.

Here’s what you need to know about Parsonage-Turner symptoms, treatments, the condition’s link to vaccines, and more.

What Causes It?

Experts aren’t sure what the exact cause is. But they’ve spotted some things that seem to trigger the symptoms, like:

  • Viral or bacterial infections (including rare reports of people getting PTS after catching COVID-19)
  • Surgery
  • Childbirth
  • Procedures like a spinal tap
  • Imaging tests that use a small amount of radioactive dye
  • Hard exercise
  • An injury
  • Cancerous cells
  • Autoimmune conditions and connective tissue disorders
  • Heroin use
  • Vaccination (this is less common)

A lot of the time, doctors can’t figure out what triggered PTS.

Vaccines, including certain ones for the flu and COVID-19, have been tied to some cases of Parsonage-Turner syndrome. A health agency in France says a small number of PTS cases have been reported after people got the Pfizer or Moderna vaccines to prevent COVID-19. It’s not clear if the COVID-19 vaccine causes PTS. More research is needed. If there is a link, it’s quite rare, as are any other serious side effects. The benefits of the vaccine far outweigh any risks.

How Common Is PTS?

It’s rare. About 1 in 1,000 people may be living with Parsonage-Turner syndrome. But there might be a number of people out there who haven’t gotten diagnosed.

It’s more common for men to get PTS than women.

What Are the Symptoms?

The symptoms of PTS may be different for you than for someone else. Where the initial pain strikes, how severe it is, and how long the pain and weakness last can vary from person to person.

PTS usually starts with sudden, severe pain in your shoulder and upper arm. It may feel sharp, achy, burning, stabbing, or throbbing. It’s rare to feel it in both shoulders or arms. For some people, the pain also goes into the neck, lower arm, or hand. It’s common to feel constant discomfort that might get worse when you move. This stage of intense pain can last for hours, days, or weeks before it starts to ease up. But you may have mild pain that lingers for a year or more.

As the pain eases, muscle weakness tends to set in, and it can range from mild to severe (nearly paralyzing). Your affected muscles could waste (atrophy), your reflexes could slow, or you could lose some feeling.

Some other possible symptoms are:

  • Partially dislocated shoulder
  • Muscles or tendons get shorter
  • Rarely, shortness of breath
  • Sweating a lot
  • Skin on hands turns red, purple, or spotted
  • Swelling

Sometimes PTS strikes nerves and muscles in the legs or diaphragm, causing symptoms in those areas, too.

How Is It Diagnosed?

Your doctor will ask you about your symptoms and give you a physical exam. They’ll likely check on the strength, reflexes, and feeling in your affected shoulder and arm.

They may recommend tests like:

Nerve conduction studies. These help you doctor find out how well a certain nerve can sense a message to your brain.

Electromyography. This test involves inserting a thin needle into your muscle to check its electrical activity. The results will tell your doctor about the health of the muscle and the nerves that control it.

MRI (magnetic resonance imaging). This painless scan uses powerful magnets and radio waves to take pictures of the inside of your body.

X-ray. This pain-free imaging test uses small amounts of radiation to take pictures of the inside of your body, usually of your bones.

What Are the Treatments?

If you’re diagnosed with Parsonage-Turner syndrome, work with your doctor to take charge of your symptoms. Some treatments for PTS are:

  • Meds to ease the initial pain
  • Heat pads or cold packs to soothe affected body parts
  • Physical and occupational therapy to improve your range of motion and strength
  • TENS (transcutaneous electrical nerve stimulation), a nonsurgical procedure that may help ease nerve pain by using low-voltage electrical impulses
  • Surgery if you have a compressed or damaged nerve or a damaged tendon

Does PTS Get Better?

Treatment can help you get better, but it may take a while to feel like your old self again. Most people recover their arm strength and function over 2 to 3 years. Getting treatment at a rehabilitation center can improve symptoms that stick around.

Still, some people get rid of their pain and recover their strength without any treatment for PTS.

Can PTS Come Back?

Yes. Even though some people get better after a single bout of pain, others have several episodes of PTS over the years.

Can It Be Fatal?

No, but there’s a chance that PTS could lead to you getting a disability.

WebMD Medical Reference

Sources

SOURCES:

Muscle and Nerve: “Parsonage Turner syndrome after COVID-19 vaccination.”

Radiology: “Parsonage-Turner Syndrome Following COVID-19 Vaccination: MR Neurography.”

National Center for Advancing Translational Sciences: “Parsonage Turner syndrome.”

Cleveland Clinic: “Parsonage Turner syndrome.”

Medscape: “New Safety Data Regarding COVID Vaccines.”

Mayo Clinic: “Electromyography (EMG).”

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