Parsonage-Turner syndrome (PTS) is a condition that affects certain nerves in the upper body. Doctors also call it brachial plexitis or brachial neuritis. The characteristic feature of PTS is sudden shoulder pain followed by weakness in the area.

The name of the condition derives from the physicians Maurice Parsonage and John Turner, who described the condition in 1948, although the original name was amyotrophic neuralgia. The condition causes muscle pain, unusual sensations on the skin, and joint pain.

PTS affects the nerves of the shoulder, arm, and hand, typically on only one side of the body. While the condition is rare, some cases may result in significant disability, which may impact a person’s quality of life.

In this article, we will discuss PTS, including what it is, its possible causes, and its symptoms.

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PTS is a rare neurological condition that affects the shoulder and arm. Characteristic features of PTS include shoulder and arm pain and wasting and weakness of the muscles in these areas.

The condition affects the brachial plexus, a network of nerves that controls movement and sensation in the arms and shoulders.

While health experts do not yet know its exact cause, the condition typically occurs following inflammation of the peripheral nerves. These are nerves that are present outside the spinal cord and the brain.

PTS is an uncommon condition, with an annual incidence of 2–3 cases per 100,000. While the condition can affect anyone, it more commonly occurs in males, and symptoms often appear in those aged 19–65.

The severity of the condition can vary — some individuals will recover, while others may experience significant disability.

There are two forms of PTS: idiopathic PTS and hereditary PTS.

Health experts do not know the exact cause of idiopathic PTS. However, risk factors for it may include:

Evidence suggests that an infection precedes the onset of PTS symptoms in 25–55% of cases. In other cases, a person may develop symptoms after a recent vaccination. For example, while this is extremely rare, there are case reports of people developing PTS after a COVID-19 vaccination.

However, health experts state that the benefits of vaccinations, such as the COVID-19 vaccine, far outweigh the risks of possible complications.

Hereditary PTS is the result of genetic changes. In 85% of hereditary PTS cases, the cause is a genetic change in the SEPT9 gene. This genetic variation results in a deficiency in proteins from the septin family of proteins.

An individual with PTS is likely to experience an acute and sudden onset of shoulder pain, typically on one side of the body. Pain occurs in 95% of individuals with PTS. The individual with PTS may describe the pain as:

  • aching, burning, stabbing, or sharp
  • continuous
  • worsening with certain movements
  • worsening at night and causing sleep disturbance

In addition to pain, a person may experience a loss of sensation and weakness in the shoulder or elsewhere in the upper body, such as in the arms and hands. The severity of the muscle weakness may range from mild to severe enough to cause complete paralysis. The affected muscles may also shrink and waste.

Unusual sensations on the skin, such as tingling, pricking, and numbness, are also a frequent symptom of PTS.

Less common symptoms of PTS include:

  • blue discoloration of the skin of the hands and feet
  • unusual skin folds
  • winging of the scapula, or shoulder blade

Diagnosing PTS may involve a physical examination, a medical history, and tests and imaging scans.

After asking about symptoms, a doctor will usually examine the upper body to look for shrinking of the muscles or winging of the scapula, which is when the shoulder blade is noticeably more prominent.

They will assess sensitivity to pain, touch, and temperature. The doctor may also test the range of movement of the shoulder, as well as shoulder strength.

Imaging tests can help rule out other conditions and confirm a diagnosis of PTS. A medical professional may request tests such as an MRI scan or an X-ray.

The doctor may also order an electromyography (EMG) test. During an EMG, a medical professional will insert a small needle electrode into the individual’s muscle. The electrode will record the electrical activity of the muscle and will show whether the muscle is responding to the nerves and whether the nerves are causing muscle weakness.

Currently, there is no specific treatment for PTS. Treatment options will depend on the severity of the condition and the symptoms the individual is experiencing. Some individuals may not need any treatment.

A doctor may prescribe medications for the pain or inflammation, such as corticosteroid medications and nonsteroidal anti-inflammatory drugs. A doctor may also prescribe specific drugs to treat nerve pain, such as:

Some individuals may need physiotherapy and rehabilitation to regain functional use of their shoulders. Such therapies may include:

  • kinesiotherapy
  • transcutaneous electrical nerve stimulation
  • deep dermal therapy
  • cryotherapy
  • functional electric stimulation

Individuals whose condition does not respond well to medication or physiotherapy may require surgery. Surgical procedures to treat PTS include nerve grafting and tendon transfer surgery. These involve taking either healthy nerve tissue or a tendon and using it to restore or replace damaged tissue.

The prognosis for PTS depends on the severity of the condition and the cause. Some individuals may recover full strength and function of the shoulder with minimal treatment. Most people regain their original strength and function within 2 years.

However, it may take more than 2 years for some individuals to regain their original strength, and they may still experience chronic pain and residual symptoms and complications. Additionally, there is a risk that PTS will return even after effective treatment. In severe cases of PTS, individuals may experience significant disability.

PTS is a rare condition that affects the peripheral nerves of the upper body. It commonly affects the shoulders and arms. Symptoms include pain, weakness, and unusual sensations in the shoulder or other parts of the upper body.

Causes of PTS can include infections, surgery, vaccinations, rigorous exercise, and genetic changes. A doctor will typically diagnose PTS through a physical exam, a medical history, and imaging tests. Treatment options can include medication, physiotherapy, and surgery.