Nerve compression syndromes about the shoulder girdle

Abstract

Purpose of review Nerve compression syndromes are important differential considerations in patients presenting with shoulder pain. This review focuses on the anatomy, diagnosis and treatment of various nerve compression syndromes, with an emphasis on the current literature. Recent findings Suprascapular nerve impingement, long thoracic nerve palsy, quadrilateral space syndrome and thoracic outlet syndrome may present with shoulder pain, paresthesias and weakness of the upper extremity. A complete history and physical examination, with use of provocative testing maneuvers, are essential in determining a diagnosis. Radiographic and electrodiagnostic studies, particularly magnetic resonance imaging and electromyography, may help isolate the nerve involved and cause of compression. The majority of patients respond to conservative management, with an emphasis on physical therapy. Recalcitrant cases may benefit from surgical intervention focusing on specific anatomic areas of compression. Summary An understanding of the relevant anatomy, combined with a thorough examination, will assist the clinician in diagnosing a specific nerve compression syndrome. Patients respond well to treatment, primarily with conservative management, or surgical decompression when symptoms persist.