Neuropathies and Nerve Entrapments Around the Scapula and the Shoulder

Nerve entrapments can occur in a number of locations throughout the body. Injury of peripheral nerves and entrapment neuropathies in the upper extremity are reported to be responsible for 2% of shoulder pain or painful instability. Nerve injury should be considered when a patient experiences pain, weakness, or paresthesia in the absence of a known bone, soft tissue, or vascular injury. The onset of symptoms may be acute or insidious. Our focus in this section will be on peripheral nerve entrapments of shoulder girdle: suprascapular nerve, the spinal accessory nerve, the long thoracic nerve, the axillary nerve, and the dorsal scapular nerve. For each nerve, we will describe the anatomy, with particular focus on the various sites of potential entrapment; then we will highlight the clinical symptoms and their associated physical examination findings; in the end we will outline the diagnostic pathway and the various possible treatment approaches.