title: Massage-induced brachial plexus injury.
abstract: OBJECTIVE
  There are few reports in the literature of adverse effects resulting from massage therapy (MT) and no reports of brachial plexus injury (BPI) associated with MT. This case report describes an uncommon case of BPI that developed after a session of MT and reviews previously published reports of peripheral nerve injury following MT.
  
  
  METHODS
  A 58-year-old Asian woman developed sudden unilateral paralysis of her left shoulder girdle after a session of MT. A diagnosis of acute BPI was suspected due to her recent history and the results of several examinations. The results of electrodiagnostic studies indicated a possible location for the lesion and ultimately led to a different diagnosis.
  
  
  RESULTS
  The patient regularly participated in a twice-weekly rehabilitation program targeting the left shoulder. The rehabilitation program included supervised passive range of motion, strengthening, and stretching exercises as well as a home exercise program. A 12-month follow-up showed the patient had achieved gradual recovery of shoulder strength, resolution of limitations of range of motion, and relief of shoulder pain.
  
  
  CONCLUSIONS
  This is believed to be the first report of BPI associated with MT. This case report serves as a reminder to massage therapists and physical therapists that MT of the neck should be carefully performed to avoid injury. Further studies will help design safer and more effective MT for the future.
authors.affiliation: C-Y. Chang, MD, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center, Taipei City, Taiwan.
authors.forename: Chih-Ya
authors.initials: CY
authors.lastname: Chang
authors.affiliation: Y-T. Wu, MD, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center.
authors.forename: Yung-Tsan
authors.initials: YT
authors.lastname: Wu
authors.affiliation: L-C. Chen, MD, MS, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center.
authors.forename: Liang-Cheng
authors.initials: LC
authors.lastname: Chen
authors.affiliation: R-C. Chan, MD, PhD, Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Rai-Chi
authors.initials: RC
authors.lastname: Chan
authors.affiliation: S-T. Chang, MD, PhD, Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan, and Department of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center.
authors.forename: Shin-Tsu
authors.initials: ST
authors.lastname: Chang
authors.affiliation: S-L. Chiang, MD, MS, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital; School of Medicine, National Defense Medical Center; and Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No. 325, Sec. 2, Chenggong Road, Neihu District, Taipei City 114, Taiwan. andyyy520@yahoo.com.tw.
authors.forename: Shang-Lin
authors.initials: SL
authors.lastname: Chiang
mesh_terms: D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis / Q000209:etiology*; D004576:Electromyography; D005260:Female; D006801:Humans; D008405:Massage / Q000009:adverse effects*; D008875:Middle Aged; D009431:Neural Conduction; D010243:Paralysis / Q000209:etiology