What is Suprascapular Nerve Compression

Suprascapular nerve compression is a type of injury caused by the entrapment of the suprascapular nerve. This nerve has motor and sensory functions in the upper trunk of the brachial plexus. It is located in the back of the neck and continues down the trapezius muscle, causing intense pain and weakness in the shoulder, especially in people who perform repetitive overhead movements, such as tennis, basketball, and volleyball players. It is most common in people between 20 and 50 years old, regardless of gender.

Suprascapular nerve injury can also be caused by:

• Trauma.
• Lifting excessive weight.
• Lipomas.
• Ganglion cysts.
• Neuropathies.

To better understand this condition, it is important to know that the suprascapular nerve covers various joints and ligaments, providing motor function to the supraspinatus and infraspinatus muscles.

Suprascapular Nerve Symptoms

Suprascapular nerve compression can cause a dull, deep pain in the back or top of the shoulder, accompanied by progressive weakening.

There are two important areas where the suprascapular nerve can get trapped:

• Suprascapular notch: The most common type of entrapment is proximal, which causes more acute shoulder pain due to the compression of deep sensory fibers. It causes weakness in the abduction and external rotation of the arm.
• Spinoglenoid notch: The distal entrapment causes less intense pain because the deep sensory fibers are outside the entrapment zone. It causes weakness in external rotation but doesn’t affect abduction.

Regardless of the type of compression, patients may report pain radiating to the neck or arm, as well as difficulty performing activities that involve lifting the arm and throwing. Muscle loss may also occur if the compression becomes chronic.

Nerve Compression Diagnosis

Diagnosis is based on a combination of medical history, physical examination, and imaging or neurophysiological studies.

The physical examination may reveal weakness in the abduction or external rotation of the shoulder, as well as localized muscle atrophy. Symptoms can also be reproduced by certain clinical maneuvers, such as applying pressure over the suprascapular notch, which helps guide the diagnosis.

To reach a confirmatory diagnosis, imaging studies like MRI are used to evaluate the muscles and rule out other structural causes such as ganglion cysts or rotator cuff injuries. Electromyography (EMG), as well as nerve conduction studies, can determine the degree of nerve damage and its exact location, differentiating between proximal and distal entrapment.

Suprascapular Nerve Entrapment Treatment

Initially, treatment is usually conservative, especially in mild or recently appeared cases. It includes physical therapy aimed at strengthening the shoulder muscles, improving posture, and reducing pressure on the nerve.

Sometimes, non-steroidal anti-inflammatory drugs (NSAIDs) and rest from activities that aggravate the symptoms are used.

The correction of biomechanical factors, such as technique in athletes, is essential to prevent the progression of the damage.

If conservative treatment doesn’t provide relief, or if there is a clear structural cause, surgical options may be considered.

Suprascapular nerve decompression can be performed through open or arthroscopic surgery, depending on the location of the entrapment.

An accurate diagnosis and specific treatment allow most patients to experience functional improvement and pain relief.

At the Neurological Center of Centro Médico ABC, we can provide you with specialized care. Contact us!