Parsonage-Turner syndrome causes sudden, intense pain in your shoulder and upper arm followed by muscle weakness. It can last for several days, weeks or months, and affects each person differently. Healthcare providers can offer many treatment options to help manage pain and muscle weakness.
Parsonage-Turner syndrome (brachial neuritis) is a neurological condition that causes sudden and severe pain in your shoulder and upper arm. The pain can last from a few days to a few weeks. Muscle weakness in your shoulder, arm, forearm or hand then follows the pain. The weakness can last for several months.
The syndrome happens due to damage to your brachial plexus. It’s a network of nerves that go from your spine through your neck, into both of your armpits and then down your arms. Parsonage-Turner syndrome (PTS) mainly affects motor nerves and axons. These nerves are responsible for controlling movement. This is why it leads to muscle weakness.
The syndrome is named after two British neurologists: Maurice Parsonage and John Turner. They described the condition in 1948. PTS is also known as:
There are usually three phases of Parsonage-Turner syndrome:
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Parsonage-Turner syndrome (brachial neuritis) is rare. Up to 3 people per 100,000 get PTS each year.
Anyone at any age can get the syndrome. But it more commonly affects men people assigned male at birth (AMAB) than women people assigned female at birth (AFAB). The average age of onset is 41 years.
Sudden pain and subsequent muscle weakness are the main symptoms of Parsonage-Turner syndrome. They can affect your:
In about 80% of cases, it only affects one arm (unilateral) — most often your dominant arm/hand. In about 20% of cases, it affects both arms (bilateral). Rarely, it can also affect your lower trunk and lower extremities.
In most cases, the pain strikes all of a sudden. It’s sharp and intense and is often worse at night. Severe pain can last for hours up to four weeks. After the pain goes away, the muscles in your affected arm will start to get weak.
You’ll likely experience muscle weakness in your shoulder or upper arm, although it can also affect your forearm and hand. Occasionally, weakness can affect your chest or diaphragm. When your muscles are weak, you lose muscle tissue over time (muscle atrophy).
The severity of the symptoms can vary widely from one person to another due to the specific nerves PTS affects. Other symptoms of PTS can include:
Researchers don’t know the exact cause of Parsonage-Turner syndrome. They think an abnormal reaction of your immune system (immune-mediated response) is the main contributor. They have two theories:
Having a recent viral infection is the most common trigger of PTS. The following viral illnesses are most typically involved:
In some cases, healthcare providers can’t determine a triggering event. In rare cases, Parsonage-Turner syndrome happens due to a genetic (inherited) condition called hereditary neuralgic amyotrophy.
Researchers believe that certain conditions and situations may make you more vulnerable to developing Parsonage-Turner syndrome. These include:
Your healthcare provider will ask about your symptoms and medical history and do a physical exam. They’ll test for muscle strength, reflexes and feeling in your arm. They may refer you to a neurologist.
If your provider thinks you have Parsonage-Turner syndrome, they may recommend a test called an EMG (electromyography). It evaluates the health and function of your skeletal muscles and the nerves that control them.
You might also have the following imaging tests to confirm the diagnosis or rule out other conditions:
There’s no specific treatment or cure for PTS — it usually goes away on its own. But early diagnosis and supportive treatments can help improve your outlook (prognosis).
Your healthcare provider will recommend certain therapies for managing your symptoms. You may have a team of specialists that crafts a care plan. This team may include:
Therapies for the acute pain phase may include:
Once the acute phase is over, your provider will likely recommend the following therapies:
In severe cases, your provider may recommend surgery if nothing else has helped your symptoms. Surgical techniques may include nerve grafting or tendon transfers.
As researchers don’t know the exact cause of PTS, there’s nothing you can do to prevent it. Certain viruses may trigger PTS, so staying as healthy as possible may help lower your chances of getting it.
The prognosis (outlook) for PTS can vary. Some people only experience one episode of PTS and fully recover their strength in the affected areas. Other people have persisting weakness and pain. And some people develop PTS more than once (recurrence).
Some factors that may increase your risk of a poorer prognosis include:
According to a study, 89% of people with PTS who received symptom management and physical therapy recovered within three years. About 75% of those people recovered within two years and 36% within the first year.
Recent studies show that many people continue to have pain and some functional issues. But a full recovery of strength is possible and can take up to eight years.
Early and correct diagnosis of Parsonage-Turner syndrome is crucial. See a healthcare provider when you have pain, especially if it’s sudden and severe.
A note from Cleveland Clinic
Experiencing sudden, severe pain can be alarming. It’s your body’s signal that something is wrong, so it’s important to see your healthcare provider as soon as possible. Many treatment options can help manage the symptoms of Parsonage-Turner syndrome (PTS) and may speed up your recovery. If you have any questions about PTS, don’t hesitate to ask your provider. They’re available to help.
Last reviewed by a Cleveland Clinic medical professional on 08/03/2023.
Learn more about our editorial process.