The entrapment neuropathy around the shoulder is a peripheral nerve injury that occurs in patients who are into sports and other occupational activities. The patient who is suffering from this injury will suffer from pain, weakness or paresthesias in the absence of a known bone, bone tissue or a vascular injury.
The symptoms can start off being acute but in some cases, can gradually worsen.
Some of the nerves in the shoulders that are affected by this are:
- Suprascapular Nerve
This injury is associated with patients involved in repetitive overhead loading. This nerve injury can also occur from a torn glenoid labrum. Sometimes, a cyst is formed at this nerve’s notch and it will compress this nerve affecting the muscles, making them weak.many times it can be an incidental finding or patient may present with pain on activities. - Axillary Nerve
This nerve can be injured when it gets entrapped as it passes through a quadrilateral space, by shoulder dislocations, repetitive overhead activities like swimming, throwing a ball etc. and sometimes from an arthroscopy or rotator cuff repair. The patients suffer from fatigue with overhead activities like throwing. - Brachial Plexus Nerve
The injury to this nerve is found mostly in sports men and women involved in collision sports. - Long Thoracic Nerve
A blow to the shoulder or activities like tennis, swimming can cause injury to the long thoracic nerve. This can cause shoulder or neck pain that worsens as overhead actions are done. - Spinal Accessory Nerve
The injury to this nerve occurs with shoulder dislocation causing pain and weakness in the shoulder.
Treatment
Non-Surgical Treatment
The doctors would prefer a non-surgical treatment before opting for a surgical treatment. Some of the non-surgical treatments include:
- Resting and protecting the injured area by immobilizing the arm using a sling.
- Avoid doing activities with the arm that can aggravate this condition.
- Doctors might suggest physical therapy to perform exercises that can help strengthen the shoulder muscles. Some of the exercises suggested include, shoulder range of motion exercises including posterior capsule stretching.
- Avoid heavy lifting.
The doctors might suggest continuing the non-surgical treatment for three to six months.
Surgical Treatment
The doctors will resort to surgical treatment when the non-surgical treatment turns out to be ineffective. The surgery’s main aim would be the decompression of the nerve. In the case of the suprascapular nerve compression, the nerve might be decompressed by excising the transverse suprascapular ligament and freeing the nerve at the suprascapular notch, where the compression usually happens.
It is usually done by arthroscopy or keyhole surgery. The doctor makes couple of tiny incisions and insert an Arthroscope. The doctor will use this camera to get a good view of the compression region. The doctor will then insert thin specialized surgical instruments through the incisions and the arthroscope is used to guide them to the compression spot and then perform the surgery, this is called endoscopic nerve release surgery .
