What is a compressed or pinched nerve, and how is it related to the shoulder?
The shoulder is an important joint that allows more range of motion than any other joint in the body. It allows the arm to move, lift, reach and bear the weight of objects. The nerves of the shoulder joint “innervate” the muscles surrounding the shoulder. Nerve innervation is a manner in which these structures connect to the muscles surrounding the shoulder joint and communicate to these muscles such that they know how and when to contract to produce coordinated shoulder motion. If a nerve near the shoulder joint is compressed, or pinched, it can disturb the way the nerve works causing significant pain, numbness and weakness in the shoulder and/or arm. A compressed or “pinched nerve” can be common in overhead athletes such as football players, volleyball players, baseball players (particularly pitchers), and those involved in racket sports like tennis. The condition occurs when a nerve function is disrupted due to repetitive traction on the nerve, direct injury to the nerve, or may occur as a result of compression on the nerve from altered anatomy, scar tissue or collections of shoulder fluid called paralabral cysts. Nerve related pain can be difficult to diagnose and treat as it can have may causes. Common causes of nerve pain around the shoulder may result from suprascapular nerve compression, quadrangular space syndrome, Parsonage-Turner syndrome, thoracic outlet syndrome, and complex regional pain syndrome. Patients in Boise, Meridian, Nampa, and the surrounding communities of the Treasure Valley have access to the orthopedic specialists at The Shoulder Clinic of Idaho who can successfully diagnose and treat shoulder pain resulting from a compressed or pinched nerve that may occur around the shoulder.
What is Suprascapular Nerve Compression?
Suprascapular Nerve Compression (SSN) or suprascapular nerve syndrome can result from a pinched nerve in one of two locations within the shoulder. This nerve is the most common nerve in the shoulder to become compressed or injured. Compression can occur when the suprascapular nerve leaves the brachial plexus (network of intertwine nerves that control movement and sensation in the arm and hand) and passes through the suprascapular notch (located at the top of the shoulder blade). This space in which the nerve travels can become excessively tight, causing a dull constant ache in the shoulder. It may also produce very specific weakness of the rotator cuff muscles which can be diagnosed by the shoulder specialists at The Shoulder Clinic of Idaho.
Suprascapular nerve compression can also occur in the area called the spinoglenoid notch (top and back of the scapula) due to the presence of a ganglion (fluid filled sack), or paralabral cyst. A shoulder ganglion, or paralabral cyst, most commonly arises from fluid leaking out of the shoulder joint caused by a SLAP lesion, or a tear of the labrum in the shoulder. This type of cyst can cause compression on the nerve in the spinoglenoid notch which results in atrophy and weakness of the infraspinatus muscle – one of the four muscles that make up the rotator cuff tendon of the shoulder.
What is suprascapular neuropathy?
Due to its location, the suprascapular nerve is vulnerable to compression at the suprascapular notch as well as at the spineoglenoid notch. Suprascapular neuropathy (SSN) is an uncommon cause of shoulder pain and is seen in patients who participate in overhead sports such as baseball, swimming or tennis. Typically, a chronic condition, which is relatively rare, suprascapular neuropathy is often not diagnosed until other more common causes of shoulder pain have already been considered. In fact, sometimes patients have surgery for these other conditions but continue to have pain due to unrecognized suprascapular nerve irritation.
Another cause of neuropathy is a traction injury. Excessive traction, or repetitive traction, can affect the way nerves work cause shoulder weakness, shoulder pain, and occasionally numbness depending on what nerves are affected. The suprascapular nerve does not produce numbness as it is strictly a “motor” nerve innervating the muscles of the rotator cuff tendon. Other nerves, however, when subjected to traction or injury, such as the axillary nerve, may produce both weakness and numbness. Injury to the long thoracic nerve – another nerve near the shoulder – may produce winging of the scapula. Scapular winging occurs when the shoulder blade that is normally flat, sticks out or “wings” away from the body. This condition may result in difficulty raising the arm due to weakness of the muscles which control the scapula, and it may also result in shoulder pain.
Can shoulder osteoarthritis cause nerve pain?
Arthritis of the shoulder can cause bony deformations called osteophytes. Sometimes called bone spurs, the osteophytes can cause severe neural pain by trapping nerves which run alongside the shoulder joint. A special type of nerve release called Comprehensive Arthroscopic Management, or the CAM procedure, can help younger, active patients gain relief from shoulder nerve pain caused by osteoarthritis.
What is Arthroscopic Nerve Release?
An arthroscopic nerve release is a sophisticated approach used by the orthopedic specialists at The Shoulder Clinic of Idaho. Patients in Boise, Meridian, Nampa, and the surrounding communities of the Treasure Valley can be treated by shoulder experts. They can use this minimally invasive technique to relase pressure placed on nerves in the spineoglenoid notch, the suprascapular notch and they can also use arthroscopic surgey to address associated intra-articular shoulder lesions such as a SLAP tear, a labral tear, or bone spurs and arthritis causing nerve pain. The surgery is done through small incisions in the shoulder, using special instruments and a tiny camera. The glenohumeral joint and surrounding shoulder spaces are explored for defects and abnormalities, and the inflamed or tight structures are modified to leave a smooth, wide space for the nerves around the shoulder to travel. This is called nerve decompression or nerve release.
For additional resources on arthroscopic nerve release, or to learn more about shoulder nerve pain, please contact the orthopedic specialists at The Shoulder Clinic of Idaho, serving patients in Boise, Meridian, Nampa, and the surrounding communities of the Treasure Valley.