Persistent Shoulder Pain Due to a Suprascapular Nerve Injury in the Setting of Trauma

Ohanisian, Levonti; Brown, Nicholas; White, StevenClaude Dorsainvil; Rubay, David; Schwartz, Paul M.

doi:10.7759/cureus.4224

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Regarding body area, our results imply that persistent enhanced pain is especially prevalent in the body areas of the neck, spine, shoulder, pelvis, hip, knee, and feet, which is also in line with earlier research (neck [ 20 ], back [ 21 ], shoulder [ 22 ], and limbs [ 19 , 23 ]). Our study results add the aspect of pelvic injuries, which have been significant predictors of enhanced pain after trauma, while other body regions did not meet the criterion of statistical significance.…”

Section: Discussionsupporting

confidence: 92%

“…The etiology of chronic pain following trauma is not well understood, but numerous retrospective studies have shown that a significant proportion of chronic pain patients have a history of traumatic injury [ 19 ]. Persistent pain after trauma can affect different parts of the body, including the neck ([ 20 ]), back [ 21 ], shoulder [ 22 ], and limbs [ 19 , 23 ]. The risk of developing persistent pain after trauma is higher in females [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Pre-Trauma Pain Is the Strongest Predictor of Persistent Enhanced Pain Patterns after Severe Trauma: Results of a Single-Centre Retrospective Study

2023

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Background and Objectives: Traumatic injuries are a significant public health issue worldwide, with persistent enhanced pain being a common complication following severe trauma. Persistent and chronic pain can have a profound impact on patients’ quality of life, affecting physical, emotional, and social functioning. This study aimed to investigate the pain patterns of trauma patients before and after severe trauma, and identify the predictors of persisting pain after injury. Materials and Methods: A total of 596 patients of a level-one trauma centre with severe trauma were included in this study. The Trauma Outcome Profile Scale was used to assess pain severity before and after trauma, and a logistic regression analysis was performed to determine the most significant predictors of relevant pain after severe trauma. Results: The mean age of the included patients was 48.2 years, and 72% were males. The most frequent cause of injury was traffic accidents, and the mean Injury Severity Score was 17.6. Nearly half of the patients experienced reduced pain-related quality of life after trauma, with persisting pain predominantly occurring in the neck, spine, shoulder, pelvis, hip, knee, and feet. Even minor injuries led to increased pain scores. Preexisting pain before injury (OR: 5.43; CI: 2.60–11.34), older age (OR: 2.09, CI: 1.22–3.27), female gender (OR: 1.08, CI: 0.73–1.59), and high injury severity (OR: 1.80, CI: 1.20–2.69) were identified as significant predictors of enhanced pain. Conclusions: These findings highlight the importance of considering pre-existing pain, body area, and injury severity in assessing the risk of persistent pain in trauma patients.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Pre-Trauma Pain Is the Strongest Predictor of Persistent Enhanced Pain Patterns after Severe Trauma: Results of a Single-Centre Retrospective Study

2023

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“…A suprascapular nerve injury manifests as a generalized shoulder discomfort and a corresponding weakness in shoulder external rotation and abduction. Eventually, the suprascapular nerve-supplied shoulder girdle muscles may atrophy [ 4 ]. Indirect mechanical compression from an underlying anatomic variation, a space-occupying lesion, or repetitive traction and irritation of the nerve at one of the anatomically predisposed sites of suprascapular nerve focal entrapment, as described below, are thought to be the primary causes of muscle wasting, atrophy, and degeneration [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Perks of a Structured Rehabilitation in Suprascapular Neuropathy Injury Post Proximal Humerus Fracture: A Case Report

Bhagwani,

Samal,

Koul

et al. 2024

Cureus

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Road traffic accidents lead to extensive damage to superficial as well as deep components in the body. Neurological structures that are affected due to open injuries have major impairments in the day-to-day life of an individual. High trauma incidents lead to nerve injuries, which are a common occurrence secondary to fractures after such falls. Nerve entrapment, nerve compression, nerve denervation, or demyelination usually result in the wasting of muscles supplied by it, which eventually causes muscle atrophy. Muscle atrophy limits the ability of an individual to move the extremities to achieve functional activities. Sensory neuropathy, in addition to motor neuropathy, is an associated complication. Physical therapy interventions are observed to play a significant role in nerve and muscle injury rehabilitation courses, thus improving quality of life. This report presents a case of a 43-year-old male who came to the hospital with complaints of pain and inability to move the shoulder after his bike was hit by a truck from behind and he experienced a fall. The patient presented to an orthopedic surgeon who took X-ray, electromyography (EMG), and nerve conduction velocity (NCV) investigations and confirmed fracture of greater tuberosity of the humerus and motor neuropathy of the suprascapular nerve. He was surgically treated and was referred to the physiotherapy outpatient department for postoperative management. A well-planned physical therapy program aimed to improve the range of motion and strength of the affected shoulder joint while preventing atrophy, thus improving quality of life.

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“…Rotator cuff dysfunction and referred cervical pain are the most common etiologies in primary care [ 1 , 2 ]. However, suprascapular neuropathy is recently becoming an important contributing factor, especially when surgery referral is needed due to pain intensity, muscle atrophy, or poor evolution [ 3 , 4 , 5 , 6 ]. Some of these pathologies result in shoulder pain, one of the most prevalent musculoskeletal conditions, representing approximately 16% of all musculoskeletal complaints [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Variations in the Course and Diameter of the Suprascapular Nerve: Anatomical Study

Montané-Blanchart

Miguel-Pérez

Rodero

et al. 2022

IJERPH

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(1) Background: Suprascapular neuropathy is an important factor contributing to shoulder pain. Given the prevalence of nerve injury and nerve block in the suprascapular notch region, as well as the frequency of arthroscopic procedures on the suprascapular notch, which are recommended in shoulder pain management, its morphology is relevant from a clinical perspective. (2) Methods: Suprascapular nerve course was studied in twelve shoulders by dissection. Its diameter was measured at omohyoid level, proximal to the suprascapular notch and distal to the spinoglenoid notch. A multi-vari chart was used in order to descriptively visualize the results. The variations found were analyzed with a mixed linear model. (3) Results: In two of the six subjects, the suprascapular nerve was divided into two motor branches proximal to the superior transverse scapular ligament. An increase in diameter around the suprascapular notch was detected, with an estimated difference between diameter means of 2.008 mm at the suprascapular notch level and 2.047 mm at the spinoglenoid notch level. (4) Conclusions: A difference in the estimated diameter detected and the fact that the motor branches, which innervate supraspinatus and infraspinatus muscle, were divided proximal to the suprascapular notch may be relevant in the diagnosis and treatment of suprascapular neuropathy and arthroscopic procedures.

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Persistent Shoulder Pain Due to a Suprascapular Nerve Injury in the Setting of Trauma

Cited by 4 publications

References 9 publications

Pre-Trauma Pain Is the Strongest Predictor of Persistent Enhanced Pain Patterns after Severe Trauma: Results of a Single-Centre Retrospective Study

Pre-Trauma Pain Is the Strongest Predictor of Persistent Enhanced Pain Patterns after Severe Trauma: Results of a Single-Centre Retrospective Study

Perks of a Structured Rehabilitation in Suprascapular Neuropathy Injury Post Proximal Humerus Fracture: A Case Report

Variations in the Course and Diameter of the Suprascapular Nerve: Anatomical Study

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