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Suprascapular Nerve Entrapment

 
SUPRASCAPULAR NERVE ENTRAPMENT
 

Description

 Suprascapular nerve entrapment is an uncommon nerve entrapment syndrome that can cause pain and weakness in the shoulder and upper back.  It is caused by compression of the suprascapular nerve at the top or back of the shoulder from a ligament, or excessive stretching. The suprascapular nerve travels in a groove at the top of the shoulder blade (scapula), which is covered by a transverse ligament. The nerve may be injured before it supplies the supraspinatus muscle or after it supplies the supraspinatus. This condition usually resolves spontaneously. Sometimes, however, surgery is necessary, especially when one or more muscles are atrophied.

Signs and Symptoms

              Poorly localized pain and discomfort in the back of the shoulder and/or top of the upper back.

          Heaviness of the shoulder and arm

          Pain is often worse with exercise or raising the arm over head

          Weakness raising the arm and/or rotating the shoulder outward  

          Atrophy (shrinkage) of rotator cuff muscles

Causes

Risks

Complications

Treatment

 Initial treatment consists of relative rest from the offending activity, compression wrap, ice, and nonsteroidal anti­inflammatory medications to help reduce inflammation and pain. Stretching exercises of the shoulder muscles may be helpful. Referral to physical therapy or an athletic trainer may be recommended for further treatment, including ultrasound and other modalities. Persistent symptoms are often relieved by an injection of corticosteroid. However, if symptoms persist after 3 to 6 months of conservative treatment, surgery may be necessary. Surgery is also indicated to relieve pressure from a cyst.