Is My Shoulder Pain Really Shoulder Pain?

Imagine for a moment that you wake up one morning with sudden, sharp left side shoulder pain. You are a healthy individual, so you automatically think, “I must have slept on it wrong.” The only problem is that your shoulder pain isn’t going away. In fact, it is becoming quite debilitating. It’s now been over a week and your shoulder pain is followed by weakness and occasional tingling down the arm. What could be going on?

You could have a pinched nerve in your neck that is causing these symptoms. Cervical radiculopathy, after all, occurs at an incidence rate of roughly 85 per 100,000 individuals.¹ Most commonly affecting the C7 level followed by the C6 nerve root.¹ The C5 and C6 nerve roots would be the most likely culprits for shoulder pain in this scenario. However, you have an MRI of your neck showing everything is in tip top shape. There is no compressed or inflamed nerve root.

Well, there is always the potential for having a rotator cuff tear. Roughly 22.1% of the general population experiences some type of rotator cuff tear.² Maybe there was a minor injury long, or not so long ago and while sleeping that night in an awkward position exacerbated the symptoms. That’s it, this is a musculoskeletal problem. You then have an MRI and X-ray of your shoulder, thinking, “this will give me my answer.” But yet again the imaging shows nothing significant. 

By now enough time has elapsed, and your shoulder pain is gone. The only thing that remains is arm weakness with some tingling. Now for the twist, just prior to all of these symptoms emergence you had the flu. This was not too much of a concern because your fever was low grade, and it seemed to be over as quickly as it started. The arm symptoms, however, overtook your attention. But little did you realize that the cause of your symptoms was because of this little virus.

Parsonage-Turner Syndrome (PTS), also known as brachial neuritis or neuralgic amyotrophy, is the cause of these symptoms. This condition is somewhat rare but is typically associated with a recent viral illness in roughly 25% of patients, followed by immunizations with 15%, and several other conditions including infection, rheumatic disease, trauma, pregnancy/childbirth, and radiation just to name a few.³ The overall reported incidence of PTS is 1.64 cases per 100,000 people.³ While this condition isn’t incredibly common is does present like some other very common ailments. If your shoulder or arm symptoms aren’t getting better and there doesn’t seem to be a clear problem indicated, we here at EMG Solutions are happy to help in any way we can.

Kyle J. Martinos PT, DPT, ECS

References

1. Magnus W, Viswanath O, Viswanathan VK, et al. Cervical Radiculopathy. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441828/
2. Minagawa H, Yamamoto N, Abe H, Fukuda M, Seki N, Kikuchi K, Kijima H, Itoi E. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop. 2013 Feb 26;10(1):8-12. doi: 10.1016/j.jor.2013.01.008. PMID: 24403741; PMCID: PMC3768248.
3. Feinberg JH, Radecki J. Parsonage-turner syndrome. HSS J. 2010 Sep;6(2):199-205. doi: 10.1007/s11420-010-9176-x. Epub 2010 Jul 30. PMID: 21886536; PMCID: PMC2926354.