Catherine M Curtin1,2, Carl-Goran Hagert3, Claes Hultling4, Elisabet Hagert4,5. 1. Department of Surgery, Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA. 2. Division of Plastic Surgery, Stanford University, Palo Alto, CA, USA. 3. Department of Orthopaedic Surgery, Lund University, Lund, Sweden. 4. Spinalis CCI Unit Karolinska University Hospital, Stockholm, Sweden. 5. Department of Clinical Science and Education, Karolinska Institutet, Hand & Foot Surgery Center, Stockholm, Sweden.
Abstract
INTRODUCTION: Many people with chronic spinal cord injury (SCI) develop shoulder pain, which can adversely impact transfers and independence. Yet effective treatments remain elusive. CASE PRESENTATION: This report presents two patients with tetraplegia who had long-standing shoulder pain. Our exam showed muscle weakness and point tenderness, suggestive of nerve entrapments of the radial and axillary nerves in the posterior shoulder. These nerves were surgically decompressed and post-operatively the patients' pain resolved. DISCUSSION: Shoulder nerve entrapments are uncommon but SCI patients may be at more risk due to their unique upper extremity demands. SCI providers should consider proximal nerve entrapments as a possible cause of shoulder pain.
INTRODUCTION: Many people with chronic spinal cord injury (SCI) develop shoulder pain, which can adversely impact transfers and independence. Yet effective treatments remain elusive. CASE PRESENTATION: This report presents two patients with tetraplegia who had long-standing shoulder pain. Our exam showed muscle weakness and point tenderness, suggestive of nerve entrapments of the radial and axillary nerves in the posterior shoulder. These nerves were surgically decompressed and post-operatively the patients' pain resolved. DISCUSSION: Shoulder nerve entrapments are uncommon but SCI patients may be at more risk due to their unique upper extremity demands. SCI providers should consider proximal nerve entrapments as a possible cause of shoulder pain.
Authors: Michael Akbar; Gabriel Balean; Manuela Brunner; Thorsten M Seyler; Thomas Bruckner; Judith Munzinger; Thomas Grieser; Hans J Gerner; Markus Loew Journal: J Bone Joint Surg Am Date: 2010-01 Impact factor: 5.284