Compression of the suprascapular nerve by a ganglion cyst. Other masses that have been described in the literature are as follows. Anatomy of nerve entrapment sites in the upper quarter. Warner chapter synopsis suprascapular nerve compression at the suprascapular notch can cause significant shoulder pathology. Isolated mononeuropathy of the suprascapular nerve. Suprascapular nerve entrapment dynamic chiropractic.
Notch is bridged by a thick transverse scapular ligament. The suprascapular nerve, supplies the supraspinatus and infraspinatus muscles. It is responsible for the innervation of some of the muscles that attach on the scapula, namely the supraspinatus and infraspinatus muscles. Often it receives contribution from the c4 nerve root as well.
Electromyographic emg, evaluation of the infraspinatus, and especially the supraspinatus muscles distinguishes sgn from ssn lesions. The nerve carries most of the pain receptors to the shoulder and rotator cuff muscles and passes through a small notch in the shoulder blade and to the back of the shoulder. Suprascapular nerve block is indicated for relief of acute shoulder pain e. The suprascapular nerve is an underrecognized cause of aching upper arm pain and weakness. The suprascapular nerve is an underrecognized cause of shoulder pain and dysfunction. We found 88 cases of suprascapular nerve entrapment, which fulfilled our inclusion.
Suprascapular neuropathy riverside pain physicians. Suprascapular notch nerve courses through the suprascapular notch. Clinical presentation nonspecific posterior shoulder pain and weakne. Cosgarea, in the athletes shoulder second edition, 2009. The suprascapular nerve provides sensory innervation to the glenohumeral joint shoulder.
Suprascapular nerve entrapment due to a stenotic foramen ncbi. Entrapment of the suprascapular nerve ssn is an increasingly recognized entity that can occur due to traction or compressionrelated etiology. Suprascapular nerve entrapment due to a stenotic foramen. The suprascapular nerve can become compressed and entrapped, resulting in unpleasant suprascapular nerve entrapment. Suprascapular nerve lesions at the spinoglenoid notch. Jan 01, 20 lafosse l, tomasi a, corbett s, baier g, willems k, gobezie r. The suprascapular nerve arises from the upper trunk erbs point of the brachial plexus in the posterior triangle of the neck.
This syndrome belongs to a group of diseases called compression syndromes, in which a nerve is compressed in one of the anatomic tunnels through which it runs. Arthroscopic release of suprascapular nerve entrapment at the. A clinician who does not know of the suprascapular. Suprascapular nerve decompression chicago sports medicine symposium, august 5 th, 2016 disclosure none relevant to this presentation anatomy upper trunk brachial plexus. Chapter 27 arthroscopic and open decompression of the suprascapular nerve umasuthan srikumaran, lewis l. This data is very important in suprascapular nerve block and. It then travels under the suprascapular notch and superior transverse ligament.
A nerve entrapment is caused when a peripheral nerve losses mobility, flexibility, or becomes compressed by surrounding tissues. A clinician who does not know of the suprascapular entrapment syndrome is unlikely to identify the nerve pathology. Suprascapular nerve entrapment treated by decompression of. Pdf suprascapular nerve entrapment caused by an intraosseous. Suprascapular nerve entrapment caused by an intraosseous ganglion of the scapula. The suprascapular nerve block is used to treat arthritis or bursitis of the shoulder joint. Suprascapular vascular anomalies as a cause of suprascapular. Suprascapular neuropathy or suprascapular nerve entrapment occurs if the suprascapular nerve is compressed as it passes through the suprascapular notch or spinoglenoid notch. It is also useful for the diagnosis and treatment of chronic shoulder pain. They were assessed at an average of 30 months 12 to 98 after operation using the functional shoulder. Lesions of the suprascapular nerve can occur at the supraspinatus notch ssn or at the spinoglenoid notch sgn. The suprascapular nerve arises from the upper trunk of the brachial plexus, which is formed from the anterior rami of the fifth and sixth. Suprascapular nerve entrapment treated by decompression of ss notch. Initially, your health care provider will embark upon conservative treatment for suprascapular neuropathy.
May 03, 2016 suprascapular nerve entrapment is characterized by pain in the posterolateral region of the shoulder, atrophy of the infraspinatus and supraspinatus muscles and weakness of the arms external rotation and abduction. It is important to be aware of neuropathy involving the suprascapular nerve. There can be many reasons for nerve entrapment, especially at the suprascapular and spinoglenoid notches where nerve deviation is limited by bony and ligamentous structures. It is known to remarkably improve pain, disability and range of movement at the shoulder. Oct 11, 2018 moore tp, fritts hm, quick dc, buss dd. Dec 04, 2018 suprascapular neuropathy typically occurs due to some sort of traction injury to the suprascapular nerve resulting in pain in the shoulders. Suprascapular nerve entrapment mimicking c5 radiculopathy. Lesions at the spinoglenoid notch suprascapular nerve entrapment inferior, snei, can be due to entrapment of the nerve beneath the spinoglenoid ligament. Suprascapular nerve entrapment is a rare condition that can be easily misdiagnosed or even go unnoticed by those who are affected. They were assessed at an average of 30 months 12 to 98. Suprascapular nerve ssn entrapment is an uncommon cause of posterior. Just medial to the coracoid, it passes through the suprascapular foramen which is formed by the suprascapular notch and transverse scapular ligament.
The location and the etiology of the compression are those that define the treatment modality. Compression of the suprascapular nerve by a ganglion cyst of. It passes through the suprascapular notch which is covered by the transverse scapular ligament into the supraspinous fossa where it supplies the supraspinatus muscle. The bone serves as a protector for many of the nerves of the back and arm that lie underneath it. There is a wide variety of mechanisms that can cause injury or compression to the suprascapular nerve during its course through the various. Operative release for entrapment of the suprascapular nerve was carried out in 35 patients. Entrapment occurs as the nerve is relatively fixed at the notch. Apr 26, 2011 diagnosis of upper extremity peripheral nerve entrapment syndromes. The suprascapular nerve specifically, arises from the superior trunk of the brachial plexus, before the medial, lateral and posterior cords are formed.
Suprascapular nerve article about suprascapular nerve by. Nerve transfer in brachial plexus injuries is a well established procedure to restore primordial functions. The anatomy of suprascapular nerve and its course through narrow osseoligamentous structures renders it susceptible to. The suprascapular nerve is responsible for the sensation in the back of the shoulder and upper arm. The suprascapular nerve is a nerve in the shoulder. Three cases of sgn lesions, which are more common than ssn lesions, are presented. Suprascapular nerve entrapment caused by supraglenoid cyst compression. Shoulder nerve injury,injuries everything you need to know dr. Nerve compression syndrome, compression neuropathy, nerve entrapment, or a pinched peripheral nerve. The nerve may be decompressed by excising the transverse suprascapular ligament and freeing the nerve at this site. Entrapment of the suprascapular nerve is a rare but increasingly recognized disease entity that contributes to pain and weakness in the posterior shoulder region. Suprascapular nerve and rotator cuff function are intimately connected. Suprascapular nerve an overview sciencedirect topics. Decompression of the suprascapular nerve shoulderdoc.
Arthroscopic release of suprascapular nerve entrapment at the suprascapular notch. Traction injuries to the suprascapular nerve most commonly occur at the suprascapular notch, where the nerve is tethered by the transverse scapular ligament. The suprascapular nerve is a nerve that arises from the brachial plexus. Suprascapular nerve compression is a rare pathology of the shoulder of nervous origin. The suprascapular nerve is a motor nerve originating from c5 and c6 nerve roots or upper trunk of the brachial plexus. Sonographic diagnosis and treatment of ganglion cysts causing suprascapular nerve entrapment. When entrapped or stretched, it can cause shoulder dysfunction and pain which over time can cause impingement syndrome and rotator cuff tendon and muscle tears. The suprascapular nerve passes through the suprascapular notch which is converted into foramen by superior transverse scapular ligament. The suprascapular nerve is the only branch of the upper trunk c5 and c6 of the brachial plexus, supplying the supraspinatus and infraspinatus muscles and sensation to the acromioclavicular and glenohumeral joints gross anatomy origin. Suprascapular nerve entrapment is an uncommon cause of shoulder pain that is being encountered more frequently in clinical practice with the increasing use of backpacks instead of briefcases. Compression injuries, on the other hand, frequently require surgical decompression for. Suprascapular nerve entrapment syndrome is caused by compression of the suprascapular nerve as it passes through the suprascapular notch.
The nerve dysfunction often results from a traction injury or compression, and a common cause is increased tension on the nerve from retracted rotator. Lafosse l, tomasi a, corbett s, baier g, willems k, gobezie r. Two possible sites of compression of the suprascapular nerve include the transverse scapular ligament and the spinoglenoid notch25 fig. Lets get to the bottom of this condition and talk about who could be affected, what body parts are involved, and what are the symptoms, causes and treatments of this potentially silent condition of the shoulder. Jan 01, 2002 suprascapular nerve entrapment should be suspected and included in the differential diagnosis of poorly localized shoulder pain in conjunction with a loss of strength in abduction and external. Especially overhead athletes such as volleyball, football, baseball, and tennis players complain of weakness and little pain. A nerve entrapment can cause neuropathic neurogenic pain that can be either acute or chronic in nature. Shoulder the suprascapular nerve is an underrecognized cause of shoulder pain and dysfunction. After leaving the brachial plexus, the suprascapular nerve passes under the trapezius and omohyoid muscles drez, 1974. The scapula is the bone that is commonly known as the shoulder blade.
Arthroscopic decompression of the suprascapular nerve. Dibak injury and or compression of the suprascapular nerve may be by a mass, most commonly a ganglion cyst. Posterior shoulder pain and arthroscopic decompression of the. Suprascapular neuropathy overview what is suprascapular neuropathy. Anatomy the suprascapular nerve ssn is a mixed nerve containing both motor and sensory fibers originating from the superior trunk of the brachial plexus c5 and c6 nerve roots.
Ligaments, articular capsule, and synovial suprascapular nerve block in the treatment of frozen shoulder. The suprascapular nerve is the only branch of the upper trunk c5 and c6 of the brachial plexus, supplying the supraspinatus and infraspinatus muscles and sensation to the acromioclavicular and glenohumeral joints. After the suprascapular nerve block, shoulder pain diminish, and an effective, relatively painfree therapeutic exercise program can be performed. Diagnosis of upper extremity peripheral nerve entrapment syndromes. Suprascapular nerve definition of suprascapular nerve by. The suprascapular nerve is a motor nerve that controls the functions of two of the main muscles on the shoulder blade. Sep 30, 2015 treatment for suprascapular nerve entrapment. Suprascapular nerve dysfunction can result from trauma, compression of the nerve by ganglion cysts, or traction from repetitive. This research was conducted to study the anatomy of the suprascapular nerve in the scapular region and its relation to both suprascapular and spinoglenoid notches. Massage therapy, manual therapy, graston technique, and active release technique art are excellent tools at addressing the muscle and fascial adhesions. Maximal stretching of the nerve with cross body adduction or protracted forward flexion. Repetitive movements, carrying heavy loads, and stretch injuries can cause injury to the suprascapular nerve.
The suprascapular nerve arises from the superior trunk of the plexus and passes laterally and a bit inferiorly toward the coracoid process. Suprascapular neuropathy radiology reference article. Several authors have hypothesized that the nerve is injured as a. Suprascapular nerve entrapment by warren hammer, ms, dc, dabco.
Suprascapular nerve block is a safe and effective treatment for chronic shoulder pain. Suprascapular nerve palsy modern manual therapy blog. Suprascapular nerve ssn entrapment at the suprascapular notch is an uncommon cause of shoulder pathology that often presents with posterior shoulder pain and wasting of the supraspinatus ss and infraspinatus is muscles. Suprascapular nerve entrapment occurs when supraspinatous nerve is entrapped in a space. Jul 31, 2015 suprascapular nerve entrapment occurs when supraspinatous nerve is entrapped in a space.
Suprascapular neuropathy typically occurs due to some sort of traction injury to the suprascapular nerve resulting in pain in the shoulders. This condition is a compression of the suprascapular nerve which can cause instability in the shoulder joint that can lead to more severe problems. The first two nerves c5 and c6 combine to form what is known as the superior trunk. Treatment for suprascapular nerve entrapment depends upon the cause, intensity, and duration of your symptoms and the amount of disability.
Causes weakness of both abduction and external rotation. Treatment for suprascapular nerve entrapment involves decreasing muscle adhesions and fascial restrictions along the suprascapular nerves path. Suprascapular nerve entrapment faqs beacon orthopaedics. Compression of the nerve may occur at two distinct locations. After departing the brachial plexus, the suprascapular nerve courses laterally through the posterior cervical triangle, posterior to the clavicle, then across the superior border of the scapular and into the suprascapular notch moen, et al. Suprascapular nerve entrapment is an uncommon cause of shoulder pain and weakness but, because of its infrequent occurrence, it is often overlooked. Suprascapular nerve block in the treatment of frozen shoulder. Compression of the suprascapular nerve by a ganglion at the suprascapular notch. Suprascapular nerve entrapment should be suspected and included in the differential diagnosis of poorly localized shoulder pain in conjunction with a loss of strength in abduction and external. The brachial plexus is a large bundle of nerves which innervates the arm and upper portions of the chest. Traction injuries of the ssn are unlikely to respond to surgical management and frequently improve with rest and avoidance of overhead activity. Commonly the 7 site of compression is at the suprascapular notch and arthroscopic decompression of the nerve 8 is an established therapeutic procedure. Suprascapular nerve injury caused by supra labral cyst. Nerve injuries associated with scapular fractures have been reported.
The ligament on shoulder blade can compress the nerve when it gets inflamed. Arthroscopic and open decompression of the suprascapular nerve. It also supplies sensory fibers to ligaments, bursa and the glenohumeral joint. Its origins are in five nerves coming from five different parts of an area known as the cervical spine from c5 to t1. While direct trauma to the suprascapular nerve is the usual cause direct blow to the base of the neck or posterior shoulder, shoulder dislocation or fracture, the problem may result from overuse injuries.
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