Re: Protruding scapula (shoulder blade)
Posted: Thu Jun 17, 2004 11:00 pm
I have had this condition twice in my life (first time I was 22, full recovery within 1 year), presently 33 years old and suffering through a similar occurance on the other side of my body (also called Parsonage-Turner Syndrome). Here's a bit of info from a medical journal:
Prognosis is generally good, since recovery of strength and sensation usually begins spontaneously, as early as 1 month after symptoms onset, with about 75% of complete recovery within 2 years. However, the period of time for complete recovery is very variable, ranging from 6 months to 5 years. It seems that the delay in recovering strength depends on the severity and duration of pain, weakness, or both.
Furthermore, patients with involvement of proximal and upper trunk lesions have the most rapid recovery. Although not very common, relapse might nevertheless occur within a few months to several years after full recovery. In general, complete restoration to normal strength and function usually occurs within five years.
However, prognosis is influenced by the duration of the resulting incapacity, some patients having experienced impairment persisting sometimes thirty years after the onset. The occurrence of diaphragmatic forms must be taken into account in the diagnostic approach of dyspnea.
No specific treatment has yet been proved efficient in Parsonage-Turner syndrome. In the early stages, pain may require treatment. Common analgesic drugs are usually sufficient. However, in many cases, high pain intensity requires morphine administration.
Corticosteroids administration does not provide any significant benefit, with the exception of a few patients who experienced some pain relief. Rest is recommended, and immobilization of the affected upper extremity may be helpful in relieving the pain and in preventing stretching of the affected muscles.
As pain subsides, physical therapy is recommended. Passive range of motion exercises of the shoulder and elbow are suggested to maintain full range of motion. Active rehabilitation is undertaken only when some recovery of the affected muscle(s) is already obtained. Furthermore, all the upper body muscles should undergo rehabilitative exercises, and not only those presenting clinical weakness. It is also recommended that strength recovery reaches a plateau before patient returns to sports.
However, the recovery delay does not seem to be improved by these physical therapies. Surgical stabilization of the scapula to the thorax, or tendon transfers have been performed with benefit in patients who did not achieve recovery.
Prognosis is generally good, since recovery of strength and sensation usually begins spontaneously, as early as 1 month after symptoms onset, with about 75% of complete recovery within 2 years. However, the period of time for complete recovery is very variable, ranging from 6 months to 5 years. It seems that the delay in recovering strength depends on the severity and duration of pain, weakness, or both.
Furthermore, patients with involvement of proximal and upper trunk lesions have the most rapid recovery. Although not very common, relapse might nevertheless occur within a few months to several years after full recovery. In general, complete restoration to normal strength and function usually occurs within five years.
However, prognosis is influenced by the duration of the resulting incapacity, some patients having experienced impairment persisting sometimes thirty years after the onset. The occurrence of diaphragmatic forms must be taken into account in the diagnostic approach of dyspnea.
No specific treatment has yet been proved efficient in Parsonage-Turner syndrome. In the early stages, pain may require treatment. Common analgesic drugs are usually sufficient. However, in many cases, high pain intensity requires morphine administration.
Corticosteroids administration does not provide any significant benefit, with the exception of a few patients who experienced some pain relief. Rest is recommended, and immobilization of the affected upper extremity may be helpful in relieving the pain and in preventing stretching of the affected muscles.
As pain subsides, physical therapy is recommended. Passive range of motion exercises of the shoulder and elbow are suggested to maintain full range of motion. Active rehabilitation is undertaken only when some recovery of the affected muscle(s) is already obtained. Furthermore, all the upper body muscles should undergo rehabilitative exercises, and not only those presenting clinical weakness. It is also recommended that strength recovery reaches a plateau before patient returns to sports.
However, the recovery delay does not seem to be improved by these physical therapies. Surgical stabilization of the scapula to the thorax, or tendon transfers have been performed with benefit in patients who did not achieve recovery.