Introduction: This is a case about a mid 30s male who came into clinic initially complaining of shoulder/neck pain coupled with significant weakness particularly in bench press and tricep exercises. This all started after getting over a viral URI. The case was classic for Parsonage Turner which is a rare condition. 1.5-3 cases per 100,000 people. This was a unique case because of the rarity and presentation in the OMT clinic. It explored how OMT can be used to treat Parsonage-Turner Syndrome. The physical exam findings and history correlation were major teaching points with this case.
Case Study: The patient presented with weakness and pain in the right shoulder and upper neck that had started after having a viral URI. He was a strength trainer and suddenly after this illness he was having significant weakness in bench press and tricep activities. While the differential is broad for this case his presenting symptoms and exam were consistent with Parsonage-Turner Syndrome. Due to the clinical diagnosis, additional studies were not deemed necessary but MRI and electrodiagnostic studies were offered. For this particular patient his pain was well controlled so Tylenol, Motrin, OMT and PT were the prescribed treatments. Other considered treatments included stronger pain medications such as opioids, neuropathy medications (Lyrica, Gabapentin, Carbamazepine, Elavil etc.) and systemic steroids. OMT was done to correct somatic dysfunctions and the symptoms were treated with OTC meds. This pathology can take months to a year to fully recover from so treatment is aimed at reducing recovery time.
Discussion: This case demonstrates the effect that a pathology can have on the body. Multiple somatic dysfunctions developed due to weakness in the right arm leading to compensation patterns. This case was different because it incorporated OMT as a treatment modality to improve symptoms and reduce recovery time. Most documented cases have reported on the efficacy of pharmaceutical management. This case was unique partially because it allowed us to treat with OMT and glean the response because the patient's pain was fairly well controlled and did not require escalation of pain medications. The initial presentation of this case was in family medicine clinic and then was referred to OMT. A more timely diagnosis could have been made and perhaps earlier intervention can lead to faster resolution of symptoms. Recognition of classic PE and history findings can help with prompt diagnosis of rarer conditions.