SHOULDER GIRDLE SYNDROME

Many patients feel confused because this condition does not come from a fall, tear, or obvious injury. Instead, it is thought to be caused by inflammation of the brachial plexus, a group of nerves that control shoulder and arm movement. Triggers may include:

The syndrome often develops shortly after you recover from a common viral infection like the flu or upper respiratory infection, suggesting an infectious trigger that prompts an abnormal immune response.

In some cases, a recent vaccination may precede the onset of symptoms by days or weeks, though this is relatively rare. The vaccine itself doesn’t cause the condition but may trigger the immune response in susceptible individuals.

Events that place significant stress on your body’s systems can act as triggers, including recent surgery, childbirth, radiation treatment for cancer, or other major medical procedures that challenge your immune system.

Certain infections can stimulate the immune response thought to be central to this disorder, causing your body's defenses to inadvertently attack nerve tissue. 

Shoulder Girdle Syndrome symptoms typically progress through distinct phases. If you experience sudden, severe shoulder pain followed by unexplained weakness, it’s best to have it assessed by a shoulder pain specialist promptly.
 

• Pain: You may experience sudden, intense pain in your shoulder or upper arm that can sometimes spread down to your hand. This pain is often worse at night, disrupting your sleep, and typically lasts between 1-3 weeks before gradually improving. The severity can be debilitating, making any shoulder movement extremely painful.
• Weakness: As the pain settles, progressive weakness usually becomes more noticeable. This is the defining feature of the condition. You may find it harder to lift your arm, keep your shoulder steady, or hold objects securely. For some, the weakness is mild; for others, raising the arm can feel almost impossible. Everyday activities—such as dressing, eating, carrying items, or working—can suddenly require much more effort and support.
• Other Symptoms: Some people may notice mild tingling or numbness in the shoulder, arm, or hand. However, changes in sensation are usually limited. The condition mainly affects muscle strength rather than feeling, which is why it is commonly referred to as paralytic neuritis.

If your Shoulder Girdle Syndrome is in the early stages, you may benefit from conservative treatments, including:
 

• Pharmalogical Therapy: Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to help minimize the severe pain and accompanying inflammation during the acute phase, providing some relief while your immune system settles.
• Physical Therapy: Physical therapy supports your shoulder while the nerves recover. Gentle strengthening helps protect weakened muscles, while guided stretching maintains shoulder movement and reduces stiffness. This approach also helps prevent muscle wasting during the healing process, allowing you to regain function safely and gradually.
• Electrotherapy Treatments: Transcutaneous Electrical Nerve Stimulation along with applications of heat and cold can help block pain signals and provide symptomatic relief during the painful phase of the condition.

If your symptoms do not improve or continue to interfere with movement, minimally invasive treatments can target the real source of pain without the need for open surgery. At Singapore Paincare, we offer precise procedures designed to relieve pain at its origin.

Nerve block injections target the inflamed nerves causing pain in shoulder girdle syndrome. They help reduce nerve irritation and inflammation, easing severe shoulder and arm pain.

Coreflex injections reduce inflammation in the surrounding muscles and ligaments that often become strained when shoulder nerves are affected.

Surgery is rarely needed and considered only when weakness does not improve over time. The goal of surgery is not to remove shoulder pain but to improve persistent weakness through nerve reconstruction or tendon transfer. Surgical options may include:

• Nerve Graft: The surgeon takes healthy nerve tissue from a different part of your body and uses it to repair or bypass damaged nerve segments in the brachial plexus, potentially restoring some nerve function and muscle control.
• Tendon Transfer: A healthy tendon from another part of your body is repositioned to replace the function of paralyzed muscles in your shoulder, compensating for lost strength by redirecting working muscles to perform the actions of damaged ones.

Since surgery carries associated risks, complications, and significant recovery time, it may not be suitable for everyone and is reserved only for cases with severe, permanent disability.

There is no proven method to prevent shoulder girdle syndrome. However, maintaining overall health may reduce risk:
 

• Eat a balanced, nutritious diet 
• Exercise regularly to maintain muscle strength 
• Seek early medical assessment for unexplained shoulder pain 

Shoulder Girdle Syndrome can be difficult to distinguish from pain that originates in the neck, such as cervical radiculopathy. When a slipped disc or bone spur in the cervical spine irritates a nerve, it may cause shoulder and arm pain that feels very similar, sometimes with accompanying weakness.

Neck-related nerve pain usually follows a recognisable nerve pathway, often extending into the forearm, hand, or fingers. In cervical radiculopathy, pain, numbness, and weakness tend to occur together. In contrast, Shoulder Girdle Syndrome more commonly affects muscle strength, with much less involvement of sensation.

Because these conditions can look alike but require very different treatments, a careful clinical examination and appropriate investigations are essential to identify the true source of pain. If brachial neuritis is not recognised and treated early, shoulder weakness may become long-lasting or permanent, affecting daily movement and independence.

At Singapore Paincare, our Painostic® method looks beyond symptoms alone. We focus on identifying the real cause of your pain and guiding you through an individualised, minimally invasive treatment plan so you can regain comfort, strength, and confidence in your shoulder again.