suprascapular nerve injury

Once considered a diagnosis of exclusion, SN is now becoming a well-recognized condition stemming from traction or compression of the nerve at some point along its course. The suprascapular nerve is a mixed nerve, meaning that it provides both sensory and motor supply for the suprascapular region. Bruce J, Dorizas J. Suprascapular nerve entrapment due to a stenotic foramen: a variant of the suprascapular notch. The relationship of the nerve to the clavicle makes it vulnerable to injury after a clavicular fracture occurs. These symptoms may get worse when you do activities that pull or press on the nerve. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Injury to the suprascapular nerve generally occurs. Br J Sports Med. Jonathan C Reeser, MD, PhD Office of Research Integrity and Protections, Marshfield Clinic Research Foundation, Jonathan C Reeser, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American College of Sports Medicine, American Medical Association, Association of Academic Physiatrists, Phi Beta Kappa, and State Medical Society of Wisconsin. Moen TC, Babatunde OM, Hsu SH, Ahmad CS, Levine WN. 92(13):2348-64. Copyright 2023, StatPearls Publishing LLC. The nerve then travels through the spinoglenoid notch around the outer edge of the scapula and into the infraspinous fossa and sends terminal branches to the infraspinatus muscle, which is below the supraspinatus muscle. Suprascapular neuropathy or suprascapular nerve entrapment occurs if the suprascapular nerve is compressed as it passes through the suprascapular notch or spinoglenoid notch. Before Ravindran M. Two cases of suprascapular neuropathy in a family. and grab your free ultimate anatomy study guide! PM&R. Gerscovich EO, Greenspan A. [QxMD MEDLINE Link]. 2012;156(5):A3719. 8600 Rockville Pike J Neurosurg. 92(13):2348-64. (https://orthoinfo.aaos.org/en/diseases--conditions/burning-thigh-pain-meralgia-paresthetica/), (https://orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/). The resulting clinical presentation depends on the location of the suprascapular neuropathy. Arthroscopy. Clin Orthop Relat Res. Although sports-related overuse mechanisms of suprascapular nerve injury are the most common causes, the SSN can also be damaged as a result of directtraumaas well as iatrogenic factors. 2000 Jun. 1999 Jan. 49(438):39-41. 2019 Feb 01;84(2):404-412. There is increasing interest in the literature regarding the clinical delineation of suprascapular nerve (SSN) injuries. Note that the cords of the brachial plexus are called the infraclavicular branches of the brachial plexus, while the nerves that branch off from the cords are the terminal branches of the brachial plexus. Link, 20. All rights reserved. Possible causes of nerve compression syndromes include: Accidents and trauma. Diagnosis and treatment. Boykin RE, Friedman DJ, Higgins LD, Warner JJ. If conservative treatment fails, subacromial injections or surgery to remove cysts or release the nerve may be required. Suprascapular Nerve Palsy - Physiopedia J Clin Ultrasound. Please enable it to take advantage of the complete set of features! Commonly, the suprascapular nerve and vein pass together superior to the ACSL and inferior to the STSL within the suprascapular notch, with the suprascapular artery passing above the STSL. This site needs JavaScript to work properly. Adv Orthop. Chronic cases may demonstrate palpable atrophy of the supraspinatus or infraspinatus muscles. [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Supraspinatus muscle helps in 0-15 arm abduction. Clin J Sport Med. MeSH Surgical intervention is considered for patients with nerve compression by an external source or for symptoms refractory to conservative measures. 2012 Jun 1;21(6):835-46. Shah AA, Butler RB, Sung SY, Wells JH, Higgins LD, Warner JJ. Report of two cases and review of the literature. 2010 Oct 6. Its important for doctors to know what anatomical variations are possible so they can diagnose and treat nerve problems in people who have these variations. Suprascapular neuropathy, resulting in shoulder pain and weakness, is frequently misdiagnosed. -. Suprascapular Nerve Injury Etiology. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. This website uses cookies to improve your experience. You also have the option to opt-out of these cookies. Am J Sports Med. The suprascapular nerve is a mixed motor and sensory peripheral nerve arising from the superior trunk of the brachial plexus. Clinically Oriented Anatomy (7th ed.). Ticker JB, Djurasovic M, Strauch RJ, et al. First described in a case study by German neurologist E.Schilf in 1952, Kopell and Thompson (1959) expanded upon compression observed at the suprascapular notch. Gray's Anatomy (41tst ed.). Curated learning paths created by our anatomy experts, 1000s of high quality anatomy illustrations and articles. Journal of shoulder and elbow surgery. 2013. If you log out, you will be required to enter your username and password the next time you visit. Pillai G, Baynes JR, Gladstone J, Flatow EL. The indirect course of the nerve, as well as its passage through two notches, makes it particularly vulnerable to injury from anatomic variation or local pathology. Broken bones and bone spurs. Arthroscopy. Many people get symptom relief through nonsurgical methods. While the underlying etiology of SSN neuropathy remains elusive, multiple compression, traction, and inflammatory pathophysiologic cascades have been previously considered. StatPearls. . 1994 Dec. 52(4):539-44. Nerve compression syndromes can affect different peripheral nerves in your upper or lower body. The suprascapular nerve is a peripheral nerve of the shoulder and arm. Suprascapular Neuropathy - Medscape Suprascapular neuropathy symptoms include: Suprascapular neuropathy usually occurs as a result of traction damage to the Suprascapular nerve. Dynamic forms of SN are often seen with overhead athletes such as volleyball players and throwing athletes. An official website of the United States government. Link, 3. Suprascapular nerve injury; Download chapter PDF 1 Introduction. National Library of Medicine This category only includes cookies that ensures basic functionalities and security features of the website. Inspection may demonstrate atrophy in the supraspinatus or infraspinatus fossae. Sonography of entrapment neuropathies in the upper limb (wrist excluded). (10) Overhead motions may exacerbate symptoms. Clinical outcomes of suprascapular nerve decompression. 1988. Difficulties with daily tasks like buttoning a shirt, typing or holding a pen. [QxMD MEDLINE Link]. Suprascapular nerve injuries with isolated paralysis of the infraspinatus. Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. The indirect course of the nerve, as well as its passage through two notches, makes it particularly vulnerable to injury. Current concepts review-suprascapular nerve entrapment. Clinical outcomes of suprascapular nerve decompression: a systematic review. Tissue swelling or damage puts pressure on the nerve, causing symptoms. At-home treatments provide symptom relief. J Shoulder Elbow Surg. Nerve Injury After Shoulder Arthroscopy, Stabilization, and - Springer [QxMD MEDLINE Link]. official website and that any information you provide is encrypted Carpal tunnel syndrome is the most common type. 13 (2):25554. Knowing any alternate nerve routes is especially crucial during surgery, so the surgeon can avoid accidentally damaging the nerve. The SSN is thought to carry cutaneous afferent fibers in only 15-25% of the general population. After supplying the supraspinatus, the nerve subsequently travels inferolaterally to wrap around the spine of the scapula at the spinoglenoid notch. The muscle rotates the arm inwards and, The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm, or humerus bone, and is one, The Pectoralis Major tendon is weakest where it inserts into the arm or humerus bone. Although the true incidence is unknown, several authors believe that suprascapular neuropathy is underreported. Patients typically complain of shoulder pain, weakness, paresthesia, and decreased range of motion. The https:// ensures that you are connecting to the J Bone Joint Surg Am. [QxMD MEDLINE Link]. The condition accounts for approximately 2-4% of all shoulder pain but is present in up to 8% of patients with a full-thickness rotator cuff tear. Vad VB, Southern D, Warren RF, Altchek DW, Dines D. Prevalence of peripheral neurologic injuries in rotator cuff tears with atrophy. Injury can be a result of compression, traction or direct trauma to the nerve. Ajmani ML. The main function of this nerve is to provide motor innervation for two muscles, which are the supraspinatus and infraspinatus muscles. The Minimum Effective Analgesic Volume of 0.5% Bupivacaine for Ultrasound-Guided Anterior Suprascapular Nerve Block. Edinburgh: Elsevier Churchill Livingstone. This concept forms the basis of the sling effect," which proposes that, in certain functional positions of the upper limb, the suprascapular nerve is exposed to damaging sheer stress in the suprascapular notch. Anesth Analg. 15. The suprascapular nerve arises from the upper trunk of the brachial plexus and receives contributions mainly from the fifth and sixth cervical nerve roots, with variable contribution from the fourth cervical nerve root. Verywell Health's content is for informational and educational purposes only. Diagnostic. The .gov means its official. Spinal root origins and innervations of the suprascapular nerve. Link, 7. Br J Gen Pract. Injury can be a result of compression, traction or direct trauma to the nerve. Atlas of Human Anatomy (7th ed.). Epidemiologic data is limited, but the prevalence of SN in overhead athletes is reportedly between 12% and 33%, and 8% to 100% in patients with massive rotator cuff tears. Disclaimer. 5(4):363366. Can Assoc Radiol J. encoded search term (Suprascapular Neuropathy) and Suprascapular Neuropathy, Brachial Plexus Injury in Sports Medicine, Cervical Spine Acute Bony Injuries in Sports Medicine, Humeral Capitellum Osteochondritis Dissecans, Infographic: Vacation Destinations to Recharge Your Batteries, FDA OKs Suflave, a Lower-Volume Colonoscopy Prep Drink. Nerve Compression Syndromes: Causes, Treatment & Prevention The nerve finally terminates within the infraspinatus muscle, innervating it. Demirhan et al reported that the spinoglenoid ligament, when present, inserts into the posterior glenohumeral capsule. Atrophy of the infraspinatus and/or supraspinatus rotator cuff muscles with resultant weakness in forward flexion and/or external rotation of the shoulder on physical examination may be demonstrated. Ferretti A, De Carli A, Fontana M. Injury of the suprascapular nerve at the spinoglenoid notch. Disclosure: Matthew Varacallo declares no relevant financial relationships with ineligible companies. PMC Hill LJ, Jelsing EJ, Terry MJ, Strommen JA. HHS Vulnerability Disclosure, Help Hill LJ, Jelsing EJ, Terry MJ, Strommen JA. This pain pattern coincides with the diffuse sensory contribution of the suprascapular nerve, as it carries sensory afferents from up to 70% of the shoulder. Knudsen ML, Hibbard JC, Nuckley DJ, Braman JP. The suprascapular nerve has four main branches, two motor and two sensory. You should see your healthcare provider early about symptoms so you can start the appropriate treatment. In roughly 15-80% of cadavers studied, the spinoglenoid (inferior transverse scapular) ligament traverses this notch, creating a tunnel through which the nerve travels. Eur J Radiol. Suprascapular nerve anatomy The suprascapular nerve is a mixed motor and sensory peripheral nerve that arises from the upper trunk of the brachial plexus. Demirhan M, Imhoff AB, Debski RE, et al. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. doi:10.1007/s00276-009-0597-5. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTI2NzItb3ZlcnZpZXc=. [QxMD MEDLINE Link]. Boykin RE, Friedman DJ, Higgins LD, Warner JJ. Casts, splints and the use of crutches can also cause nerve problems. Nerve compression syndromes can result from pressure on a peripheral nerve. The spinoglenoid ligament and its relationship to the suprascapular nerve. The suprascapular nerve supplies sensation to several shoulder structures, including the coracohumeral ligament, coracoacromial ligament, subacromial bursa, acromioclavicular joint, and glenohumeral joint. Athletes may also describe weakness and a sense of fatigue during these activities. Suprascapular nerve. Treatment typically includes rest with avoidance of activities that place sustained or repetitive stress on the nerve. 2007 Dec. 36(12):1032-5. Reviewer: 1994 Sep. 13(9):671-4. Br J Sports Med. Am J Phys Med Rehabil. Inokuchi W, Ogawa K, Horiuchi Y. (11) Pathoanatomically, more proximal lesions tend to produce both sensory and motor complaints, while more distal lesions (i.e. Electromyography and Neuromuscular Disorders, Clinical-electrophysiologic Correlations, 3rd Edition. Use a wrist rest with your keyboard and mouse pad. [32], Studies have reported that 13-33% of elite volleyball athletes have signs of suprascapular neuropathy. [QxMD MEDLINE Link]. 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