Also known as Brachial Neuritis
Quick Summary
- Axillary nerve injury usually follows shoulder trauma (dislocation, fracture, heavy blow) and mainly weakens the deltoid muscle.
- Parsonage-Turner Syndrome (PTS) is a rare, immune-driven condition that starts with sudden, severe shoulder pain and later causes patchy muscle weakness in the shoulder and arm.
Early diagnosis and a structured rehab plan prevent stiffness and maximise recovery.
Is It Axillary Nerve Injury or PTS?
Feature | Axillary Nerve Injury | Parsonage-Turner Syndrome |
Typical trigger | Fall, shoulder dislocation, fracture, surgery | Often none; can follow infection, vaccine, heavy exercise |
First symptom | Dull ache or numbness after the injury | Sudden, burning/knife-like pain (often at night) |
Weakness pattern | Can’t lift arm sideways; shoulder looks flat | “Patchy” weakness – deltoid, rotator cuff, biceps, serratus anterior |
Sensation changes | Numb patch over outer shoulder (“regimental patch”) | Tingling/numbness in upper arm or forearm; ± skin changes |
Course | Gradual improvement over months; surgery if no recovery | Pain fades in weeks → weakness peaks → slow recovery over 6–18 mths |
When to Seek Help
- You cannot lift your arm above shoulder height.
- Shoulder pain wakes you at night or lasts > 7 days.
- Visible wasting of shoulder muscles.
- New tingling in the outer arm or fingers.
How Doctors Confirm the Diagnosis
- Physical examination – strength, sensation, reflexes.
- Imaging
- X-ray/ultrasound → rule out fracture or rotator-cuff tear.
- MRI → shows nerve swelling, hidden masses, or muscle changes.
- Nerve tests (EMG / NCS) – measure electrical signals to confirm damage and track recovery.
Treatment Road-Map
- Axillary Nerve Injury
Phase | Goals | Typical Time-Scale* |
0-6 wks | Sling only as needed, pain control, gentle movement | 0-6 weeks |
6-12 wks | Strengthen deltoid & rotator cuff, restore full range | 6-12 weeks |
6 mths | Repeat EMG – if no nerve signals, consider surgery | Decision at ~6 mths |
< 9 mths | Nerve graft or transfer if required | Best before 9 mths |
- .Parsonage-Turner Syndrome
Phase | Goals | Typical Time-Scale* |
Pain phase | Strong analgesia (NSAIDs ± short steroid taper), comfortable positioning | Days–weeks |
Weakness phase | Start physio once pain eases: active range, gentle strengthening | Weeks–months |
Recovery phase | Progressively load muscles, monitor EMG, prevent stiffness | 6–18 months |
*Individual recovery varies with age, overall health, and severity.
Everyday Tips
- Ice 15 min, 3× daily in week 1 to ease pain and swelling.
- Support the arm in a sling only for short spells; prolonged rest stiffens the joint.
- Sleep propped up on pillows during the painful phase of PTS.
- Log milestones (e.g., brushing hair, fastening seat belt) – tiny gains signal nerve recovery.
- Avoid overhead weights until cleared by your physio/consultant.
Frequently Asked Questions
Will my pain go away?
Yes. In PTS the intense pain usually settles within a few weeks. After a traumatic axillary-nerve injury, pain improves once the joint is stable and swelling subsides.
Do steroids cure PTS?
A short course can shorten the painful phase but doesn’t change long-term nerve recovery.
Will I get full strength back?
Most patients regain near-normal strength by 18–24 months. Early physiotherapy and avoidance of prolonged immobilisation improve the outlook.
Is surgery dangerous?
Nerve graft or transfer is safe in experienced hands. Timing is vital – surgery before 9 months gives the best chance for the deltoid to re-innervate.
Key Take-Home Points
- Axillary nerve wraps round the neck of the humerus and is vulnerable in dislocations.
- In PTS, pain often disappears just as weakness appears – a classic clue.
- Nerves heal slowly; first flickers of movement may take 3 months, full power 12–24 months.
- Early, guided physiotherapy prevents frozen shoulder and promotes nerve-muscle reconnection.
- Surgery is rare in PTS but may restore function after severe axillary-nerve trauma.
Call to Action
If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk
Disclaimer
This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.
This page was last clinically updated May 2025