Baseball pitchers, tennis players and others whose activities entail repeatedly reaching above their heads are vulnerable to a relatively rare condition called suprascapular neuropathy. It causes shoulder pain and dysfunction.
As Dr. Dana P. Piasecki and associates noted in a review article for the journal of the American Academy of Orthopaedic Surgeons, the Suprascapular Neuropathy results from the stress that arm stretching and rotating movements place on the shoulder. The suprascapular nerve is injured by excessive stretching, kinking and friction.
The nerve extends from the neck to the back of the shoulder, in a narrow passageway through bones and ligaments. The nerve can become compressed, or entrapped, at several points. Ganglion cysts and masses of soft tissues are sometimes responsible, though much of the time the compression is an overuse injury resulting in Suprascapular Neuropathy.
Retracted rotator cuff tears can cause Suprascapular Neuropathy in older patients. Nearly one-third of the time, suprascapular nerve injury is associated with shoulder dislocations or humerus fractures, according to the article.
More than 80 percent of those with suprascapular neuropathy report pain and spinal weakness. Patients have described the discomfort as a dull, ocassionally burning, ache in the shoulder that sometimes extends to the neck and arm. Reaching across the torso, or rotating the shoulder, may be particularly painful.
Most patients who undergo nonsurgical treatment for Suprascapular Neuropathy enjoy reduced pain. They regain shoulder function by modifying their physical activities, taking anti-inflammatory medication and receiving physical therapy.
For others, “muscle bulk and motor strength may be irreversibly lost” due to atrophy, Piasecki et al noted. Surgery might be necessary to allow for shoulder function to return. The procedure typically involves widening the spinoglenoid or suprascapular notch, points at which the nerve tends to sustain injuries. This can be done as open surgery or arthroscopically.
A study by Kim et al, involving 31 patients, found that the procedure produced long-term pain relief and restored strength in more than 90 percent of the Suprascapular Neuropathy cases. In another study, arthroscopic suprascapular notch decompression significantly helped all 10 patients. Surgeons sometimes perform open spinoglenoid decompression while arthroscopically repairing related labral tears.
In research featuring patients with spinoglenoid notch entrapment resulting from ganglion cysts, all six participants reported that they no longer felt any pain after undergoing decompression surgery. Another study showed that the procedure resulted in significant nerve recovery, pain relief and restored function for patients diagnosed with suprascapular neuropathy and large rotator cuff tears.