Brachial Neuritis: Pain You Shouldn't Ignore

Written by Helen Colledge and Matthew Solan | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

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

Brachial neuritis can cause severe pain in your shoulder and, when this subsides, your shoulder may be weak, limiting your movement.

Brachial neuritis is uncommon. The condition often begins suddenly, and frequently the pain will begin during the night.

Other names for brachial neuritis include neuralgic amyotrophy and Parsonage-Turner syndrome.

There are two main types: idiopathic brachial neuritis and an inherited form. The most common is idiopathic, which may result from your own immune system attacking your nerves, although doctors do not understand exactly how the nerve damage develops in either one.

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What Causes it? Who is at Risk?

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

While the cause remains unknown, brachial neuritis is known to occur in association with certain factors, which include:

  • a recent infection caused by bacteria or viruses
  • a parasite infestation
  • illnesses such as systemic lupus erythematosus
  • vaccinations
  • accidental injury elsewhere in the body
  • surgery
  • medical procedures such as a lumbar puncture
  • giving birth

What are the Symptoms of Brachial Neuritis?

Although the duration and severity of each phase may vary according to the individual, brachial neuritis generally begins with pain, which leads to a period of muscle weakness. The symptoms you may experience include:

  • sudden, intense shoulder pain, most often in the right shoulder, but sometimes in both
  • the pain is described as stabbing or burning
  • the pain becomes worse if you move your shoulder
  • the pain is only relieved by the strongest painkillers, and remains constant for a number of hours or even weeks
  • as the pain goes away, some of your shoulder muscles are weak or even paralyzed
  • wasting of muscles
  • occasionally, areas of numbness that develop in your arm or shoulder
  • shortness of breath if the nerve to your diaphragm is affected

How is it Diagnosed?

Your doctor will ask you about your condition and conduct an examination to look for painful or wasted muscles as well as test your shoulder movement and strength. In some people, the shoulder blade on the affected side protrudes and your doctor will check for this. You may also have your reflexes and skin sensation tested to look for any abnormalities.

Blood tests may be used to look for any underlying illnesses.

Your doctor may order X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans 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.

What are the Treatments?

Medication and Exercise

Initially, your treatment will involve pain-killing drugs to relieve the intense pain. Once your pain is controlled, doctors will focus on helping your arm and shoulder regain normal function. To strengthen your muscles, you may need a program of passive and active exercises for up to eight weeks. A physiotherapist will supervise your exercises.

Surgery

For the minority of people whose symptoms fail to improve, doctors may recommend surgery. This might be suggested if you still have not 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.

What is the Long-Term Outlook?

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

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