His Arm Felt Weak After a Race; Doctor Performs 'Thumb Test' and Knows Right Away
A simple test helped a 24-year-old man bounce back from a rare syndrome that sucked the strength from his left arm.
The story was told in The New York Times Magazine by Dr. Lisa Sanders, who said the man she wrote about — his name was withheld — experienced a rapidly increasing loss of strength in his left arm after running in the 2017 New York City Marathon.
It wasn’t until the man was well into a gamut of medical tests that he realized the loss of strength had been growing even before the race.
“It wasn’t painful, just odd — as if he’d somehow lit a sparkler deep inside the joint, right above the shoulder blade,” Sanders wrote. “It only lasted a few seconds, and he wouldn’t have thought twice about it if it hadn’t become a frequent event when he ran. By the time he felt ready for the race, the tingle would twang through his shoulder dozens of times, usually in the last leg of a particularly long run. But it hadn’t really hurt, and he never noticed any weakness until the marathon.”
In the hunt for a cure, the man bounced from a surgeon to a physical therapist to a physiatrist (a rehabilitative-medicine specialist) and then to a neurologist for a test of nerve function in the arm.
Enter Dr. Mark Sivak, who was told how the problem developed and tested the strength of the man’s arms.
“Then he had the young man bend his thumb at the last joint,” Sanders wrote. “He put a downward pressure on the nail and instructed the man to straighten his thumb. It was easy on the right. But impossible on the left.”
“I think I know what’s going on,” Sanders quoted Sivak as saying.
The diagnosis? Parsonage-Turner syndrome, an inflammation of the nerves connecting the spinal cord to the shoulder and arm, the neurologist explained.
Recovery began with steroids and progressed to physical therapy. After two years, the patient Sanders wrote about “still does the stretching exercises that he was taught in physical therapy two years ago and feels as if the pain and weakness creep back if he stops.”
The man Sanders described was lucky. As she noted, the disease can lead to muscle wasting.
In the case of Baylor basketball player Jake Lindsey, it meant quitting the sport while still in college after he was diagnosed with Parsonage-Turner syndrome, according to USA Today.
It began when he needed hip surgery, Lindsey wrote on Baylor’s website.
“A few days after my surgery, I started suffering nerve pain in the area around my left shoulder,” he wrote. “For those of you who have experienced nerve pain, you understand that it’s just a different beast. There are really no words I can use to describe what exactly was happening in my shoulder area, except to say it really wasn’t all that fun.
“The pain continued for about three to four days. After that time period, I was able to start moving around on crutches, but something just wasn’t right. I crutched around for several weeks, but it felt like part of my left side was still numb, and it made the rest of the muscles in my left arm and neck area very sore and tight.”
Then came his test when doctors said he had irreparable muscle damage from the disease.
The precise cause of the disease is unclear.
“I reached around to feel the muscles they described as being affected,” Lindsey said. “Gone. Where those two muscles were supposed to be, there was kind of this weird crater in my back. It was as if my back muscles were a balloon, and someone took a pin and popped it.”
“Parsonage-Turner Syndrome may develop after a viral illness, mild trauma, physical exertion or even surgery, but often the cause is not obvious. The most common theory as to its cause is that of a viral-induced, immune-mediated process,” according to Massachusetts General Hospital, which noted that “In rare instances, this weakness can progress to complete paralysis of the involved muscles.”
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