Understanding Parsonage Turner Syndrome
What is Parsonage Turner Syndrome?
Parsonage Turner Syndrome sounds scary, but think of it like this: your shoulder's electrical system has gone haywire. Just like when the lights flicker in your house during a storm, the nerves that control your shoulder muscles get inflamed and stop working properly.
This condition goes by several names - you might hear it called brachial neuritis, neuralgic amyotrophy, or acute brachial neuropathy. But they all describe the same thing: inflammation of the nerves that run from your neck down to your shoulder and arm.
Here in Durango, I've seen this condition affect everyone from retired ranchers to grandparents who love to garden. One patient described it perfectly: "Doc, it felt like someone hit my shoulder with a baseball bat in the middle of the night, and then my arm just wouldn't work right."
What Causes It?
The honest answer is that we don't always know exactly what triggers Parsonage Turner Syndrome. Sometimes it happens after:
A viral infection (like a cold or flu)
Recent surgery or medical procedures
Vaccinations
Physical trauma or injury
Severe stress on the body
But sometimes it just appears out of nowhere. I've had patients in Cortez and Pagosa Springs who developed it after seemingly normal activities like lifting grandchildren or working in their gardens.
How Common Is It?
This isn't something you hear about every day. It affects about 1 in 1,000 people each year. Men get it slightly more often than women, and while it can happen at any age, I see it most commonly in people between 40 and 60 years old.
What Are the Symptoms?
The symptoms usually come in two stages, like a storm that hits hard and then settles into a steady drizzle.
Stage 1: The Pain Phase (Usually lasts 2-4 weeks)
The pain is often the first and worst symptom. Patients tell me it's unlike anything they've felt before:
Sudden, severe shoulder pain that can wake you from sleep
Sharp, burning, or aching pain that may spread down your arm
Pain that gets worse at night
Pain so intense that even gentle touch hurts
One rancher from Farmington told me, "I've been thrown by horses and broken bones, but this pain was something else entirely. I couldn't even wear a shirt without it hurting."
Stage 2: The Weakness Phase (Can last months to years)
As the pain starts to fade, you'll likely notice:
Weakness in your shoulder, arm, or hand
Difficulty lifting your arm overhead
Trouble with daily activities like combing your hair or reaching into cabinets
Your shoulder blade might "wing out" or stick out from your back
Muscle shrinkage (atrophy) in affected areas
Which Muscles Are Usually Affected?
The most commonly affected muscles control:
Lifting your arm away from your body
Rotating your shoulder
Moving your shoulder blade
Sometimes finger and wrist movement
How Do We Diagnose It?
When patients come to my office in Durango with these symptoms, I use several approaches to confirm the diagnosis:
Physical Examination
I'll check:
Your range of motion
Muscle strength in different positions
Reflexes
Sensation in your arm and hand
Medical Tests
Nerve Studies (EMG/NCS): These tests measure how well your nerves are working. Think of it like testing the wiring in your house. The test involves small electrical impulses - most patients find it uncomfortable but tolerable.
MRI: This helps us see the muscles and can show if there's inflammation or other problems we need to rule out.
Blood Tests: Sometimes we check for infections or other conditions that might cause similar symptoms.
What We're Looking For
The key signs that point to Parsonage Turner Syndrome:
Sudden onset of severe shoulder pain followed by weakness
Specific pattern of muscle weakness
Normal sensation (feeling) in most cases
EMG changes that show nerve inflammation
Treatment Options
The good news is that most people with Parsonage Turner Syndrome do get better, though it takes time and patience. Treatment focuses on managing pain and maintaining function while your nerves heal.
Pain Management
Early Phase (First few weeks):
Strong anti-inflammatory medications
Sometimes steroid medications to reduce inflammation
Pain medications as needed
Ice or heat (whichever feels better to you)
I often tell patients in Pagosa Springs, "Think of this like treating a severe sunburn from the inside out. We need to calm down the inflammation first."
Physical Therapy
Once the severe pain settles down, physical therapy becomes your best friend. A good therapist will help you:
Maintain range of motion in your shoulder
Prevent stiffness and frozen shoulder
Strengthen muscles that aren't affected
Learn new ways to do daily activities
Gradually rebuild strength as nerves heal
I work closely with excellent physical therapists throughout the Four Corners area who understand this condition.
Activity Modification
While you're healing:
Avoid heavy lifting or repetitive overhead activities
Use adaptive equipment when needed (long-handled shoehorns, reachers)
Take breaks during activities
Listen to your body - some days will be better than others
Advanced Treatment Options
For severe cases or when conservative treatment isn't enough, we might consider:
Platelet-Rich Plasma Therapy: This uses your own blood components to potentially speed healing.
Nerve Blocks: Injections that can provide longer-lasting pain relief.
Surgery: Rarely needed, but sometimes we perform nerve repair surgery or tendon repair surgery if certain nerves don't recover.
What to Expect: The Recovery Timeline
Recovery from Parsonage Turner Syndrome is like watching grass grow - it happens, but you have to be patient. Here's what most patients experience:
Weeks 1-4: Pain Phase
Severe pain gradually decreases
Weakness becomes more noticeable as pain improves
Focus on pain management and gentle range of motion
Months 2-6: Early Recovery
Pain continues to improve
Weakness may seem worse (but it's just more noticeable)
Physical therapy becomes more important
Some muscle wasting may be visible
Months 6-12: Active Recovery
Gradual return of strength
Continued improvement in function
May still have some limitations with overhead activities
1-3 Years: Long-term Recovery
Most people see their best recovery by 2 years
Some may have lingering weakness or occasional discomfort
Many return to full activities, though some adapt their approach
Success Stories from Durango
I've treated a retired teacher who thought she'd never be able to write on a whiteboard again. With patience and therapy, she returned to substitute teaching within 18 months.
A rancher from Cortez was devastated when he couldn't lift hay bales. We worked together on alternative techniques, and while he approaches some tasks differently now, he's back to managing his property.
Living with Parsonage Turner Syndrome
Daily Life Adaptations
In the Kitchen:
Use lightweight cookware
Keep frequently used items at waist level
Consider a small cart to move things around
Getting Dressed:
Button-front shirts are easier than pullovers
Adaptive tools can help with buttons and zippers
Dress the affected arm first, undress it last
Around the House:
Use long-handled tools for cleaning
Reorganize storage so you don't need to reach overhead
Ask for help with heavy tasks - your neighbors in Durango are usually happy to lend a hand
Emotional Support
Dealing with sudden disability is tough. Many patients go through stages similar to grief:
Shock and denial ("This can't be happening")
Anger and frustration ("Why me?")
Depression ("Will I ever be normal again?")
Acceptance and adaptation ("I can work with this")
This is completely normal. Consider:
Joining support groups (online communities can be helpful)
Counseling if you're struggling emotionally
Staying connected with friends and family
When to Call Dr. Butzen
Contact our office in Durango if you experience:
Sudden worsening of symptoms
New areas of weakness or numbness
Signs of infection if you've had injections
Severe depression or anxiety
Questions about your recovery progress
Follow-up Care
Regular check-ins help us monitor your progress and adjust treatment. Typical follow-up schedule:
2-4 weeks after initial diagnosis
Every 2-3 months during active recovery
Every 6 months during long-term recovery
Frequently Asked Questions
Will I get this again? Parsonage Turner Syndrome rarely affects the same person twice, though it can occasionally happen on the opposite side.
Can I prevent it? Since we don't know exactly what causes it, there's no sure way to prevent it. Staying healthy overall is always good advice.
Should I avoid vaccinations? No. While vaccinations can rarely trigger Parsonage Turner Syndrome, the benefits of vaccination far outweigh this small risk.
Will I need surgery? Most people don't need surgery. We only consider surgical options like nerve repair surgery or tendon repair surgery in severe cases where conservative treatment hasn't helped.
Can I still work? Many people return to work, though you might need accommodations initially. We can provide documentation for your employer if needed.
What about driving? Once the severe pain phase passes and you have adequate strength and range of motion, most people can return to driving. Start with short trips close to home.
Resources and Support
Local Resources in Durango and the Four Corners:
Animas Orthopedic Associates: (970) 259-3020
Local physical therapy clinics
Durango Community Recreation Center (adapted fitness programs)
Southwest Colorado Area Agency on Aging (adaptive equipment loans)
Online Resources:
The Foundation for Peripheral Neuropathy
American Chronic Pain Association
Occupational therapy self-help resources
Remember:
Recovery takes time, but most people with Parsonage Turner Syndrome do get significantly better. Some have complete recovery, others adapt and find new ways to do the things they love.
You're not alone in this journey. Here in Durango, we're committed to helping you through every step of your recovery. Whether you need rotator cuff surgery, shoulder pain evaluation, or non-operative shoulder treatment, our team has the experience to help you get back to the activities that matter most to you.