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Brachial Neuritis: Pain You Shouldn’t Ignore

What is brachial neuritis?

If you have brachial neuritis, the nerves that control your shoulder, arm, and hand become inflamed. These nerves run from your spinal cord along your neck and shoulder into your arm and form what’s known as the brachial plexus.

Brachial neuritis can cause severe pain in your shoulder. When this pain subsides, your shoulder may be weak, limiting your movement. This is a rare disorder that often begins suddenly, with pain frequently beginning during the night. Brachial neuritis is also called neuralgic amyotrophy or Parsonage-Turner syndrome.

The two main types of brachial neuritis are idiopathic and inherited. The most common type is idiopathic. It may be the result of your immune system attacking your nerves. However, doctors don’t understand exactly how the nerve damage develops in either type.

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Symptoms

What are the symptoms of brachial neuritis?

Brachial neuritis generally begins with pain, which leads to a period of muscle weakness. How long and how severe each of these phases is can vary from person to person. The symptoms of brachial neuritis include:

  • sudden, intense shoulder pain that’s often described as stabbing or burning, usually in the right shoulder, but sometimes in both
  • pain that becomes worse if you move your shoulder
  • pain that’s only relieved by the strongest painkillers and remains constant for a number of hours or even weeks
  • weakness or paralysis in the shoulder muscles as the pain goes away
  • muscle atrophy, which is a decrease in muscle mass
  • areas of numbness that occasionally develop in your arm or shoulder
  • shortness of breath, which occurs if the nerve to your diaphragm is affected

Causes

What are the causes of brachial neuritis?

The cause of brachial neuritis is unknown.

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Risk factors

What are the risk factors for brachial neuritis?

You’re more likely to get brachial neuritis if you’re male. Although the condition can occur at any age, those over age 20 and below age 60 are the most frequently affected.

Diagnosis

How is brachial neuritis diagnosed?

Your doctor will ask you about your condition and conduct an examination to look for painful or wasted muscles. They’ll also test your shoulder movement and strength. In some people, the shoulder blade on the affected side protrudes or stands out more than usual, and your doctor will check for this. They may also test your reflexes and skin sensation to check for any abnormalities.

Your doctor may order X-rays, CT scans, and MRIs of your neck and shoulder. The scans can help rule out other causes, such as a slipped disc or tumor, which could press on the nerves and cause similar symptoms.

Electrical testing may be performed to show whether individual nerves are functioning correctly. Your doctor may also use blood tests to look for any underlying illnesses.

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Treatments

What are the treatments for brachial neuritis?

Brachial neuritis can often be treated with a combination of medication and physical therapy. However, in rare cases, your doctor may say you need surgery.

Medication and exercise

Initially, you will be treated with painkillers. Once your pain is controlled, your doctors will focus on helping your arm and shoulder regain normal function. To strengthen your muscles, you may need to follow a rehabilitative program of passive and active exercises for up to eight weeks. A physical therapist will supervise your exercises.

Surgery

If your symptoms don’t improve, your doctor may recommend surgery. They might suggest this if you still haven’t recovered after a period of about two years. During surgery, damaged nerves can be repaired using grafts taken from healthy nerves. The procedure should restore your muscle function. Tendon transfers can also be used to restore function. 

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Outlook

What’s the long-term outlook?

In most cases, you can expect the pain of brachial neuritis to lessen after several days or weeks. The muscle weakness should resolve within a few months. As a general rule, the longer the painful period lasts, the longer your overall recovery will take. Some people find that their muscle weakness lasts for a number of years, and a few are left with a permanent, although slight, loss of strength.

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