Not Your Bread And Butter Shoulder Pain

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Not Your Bread And Butter Shoulder Pain - Page #4

Working Diagnosis: Parsonage-Turner syndrome Treatment: PT Over the counter acetaminophen and ibuprofen as needed for pain control. Outcome: Patient is now 3 months out since symptom onset. Shoulder pain 90% improved but weakness remains relatively unchanged (patient reports subjective 10% improvement in strength) Author's Comments: Neuralgic amyotrophy aka brachial neuritis aka Parsonage-Turner syndrome is a rare disorder of the lower motor neurons of the brachial plexus (or other peripheral nerves) which typically presents with acute onset severe unilateral shoulder pain followed by flaccid paralysis of the respective innervated muscles. This patient has none of the typically sited "triggers" (i.e. recent viral illness or vaccination), but he does report a history of recent unaccustomed strenuous exercise (chest fly), which has been linked to Parsonage-Turner syndrome. He was prescribed a Medrol dose pack by his PCP within 1 month of symptom onset. Limited data does suggest that early use of PO steroids leads to faster recovery of pain and strength. The patient understands that pain and weakness may linger for several months. He is motivated to continue with PT and OT. References: 1. Medscape 2. Hussey AJ, O'Brien CP, Regan PJ. Parsonage-Turner syndrome-case report and literature review. Hand (N Y) 2007 Dec;2(4):218-21. Return To The Case Studies List.		Back
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