The basic function of nerve is like a messenger. It carries messages to and fro from brain and spinal cord to different parts of the body. To carry out its function, nerve has to pass through several channels, tunnels in bones and tissues to innervate at its designated place. While passing through these passages, nerve is vulnerable to get entrapped and compressed between tissues or in narrowed space.
Suprascapular nerve entrapment is one such condition that is responsible for pain and weakness in the shoulder. Entrapment of this nerve is uncommon, and it is mostly observed in people playing tennis, volleyball and other contact sports. Supraspinatus nerve supplies supraspinatus muscle and infraspinatus muscle in shoulder.
In most cases there is spontaneous resolution of this condition. In some cases, surgery may be necessary to release the entrapped nerve.
Causes Of Suprascapular Nerve Entrapment
Suprascapular nerve entrapment occurs when supraspinatous nerve is compressed or is entrapped in a space. Most cases of entrapment occur when the nerve passes through scapular ligament. The nerve can be compressed due to pressure from a cyst. The ligament on the shoulder blade can compress the nerve when it gets inflamed. When the hand and arm is repeatedly stretched overhead in certain sports and other activities, it can cause suprascapular nerve compression.
People playing certain sports are more vulnerable to suprascapular nerve entrapment. Tennis, volley ball, basket ball, and several other sports where the arm is stretched overhead repeatedly can cause suprascapular nerve entrapment. Aside from sport activity, this condition can also occur due to direct injury to the arm, especially injury in the posterior triangle in the neck.
Suprascapular Nerve Entrapment Symptoms
The clinical features of suprascapular nerve entrapment are characteristic. They easily help the physician in diagnosing the condition. The symptoms can be gradual or spontaneous in onset. One of the most prominent symptoms is pain in shoulder and upper back and top of the shoulder. In some cases pain radiates to the arm.
Besides pain, patient experiences weakness in arms while lifting any substance. He is not able to lift his hand above the head as before. Pain becomes worse with movement of arm, especially while combing or playing. After a period of time, there is wasting of supraspinatous and infraspinatous muscle.
Treatment For Suprascapular Nerve Entrapment
Suprascapular nerve entrapment is not as common as other nerve entrapment. However when present it needs to be treated in time because of the risk of permanent weakness in the shoulder and pain. In majority of cases the treatment is conservative. However, if treatment measures fail and the condition begins to worsen, the surgeon may think of surgical option to relieve the compression.
Initially patient is explained to take rest from the activities that he used to perform daily. Rest given to the area will allow the inflammation of the tissue responsible for entrapment to subside.
Ice fomentation daily for few days will help in reducing inflammation. Put few ice pieces in a clean cloth and place it over the affected area for 10 minutes. Repeat this procedure after every few hours. After few days when the suprascapular nerve has recovered, physiotherapy will be useful to strengthen the arm and the muscles. Sometimes painkillers and anti inflammatory medications may be required if pain is severe.
If the condition worsens, or the symptoms persist even after 3 to 6 months of conservative treatment, surgery may be required.