What is suprascapular nerve impingement? This nerve runs through a narrow tunnel that is formed by the bony ridges of the shoulder blade (scapula). This tunnel is called the suprscapular notch. In some individuals the nerve gets pinched in this notch.
Why is it difficult to diagnose? The patient will mostly complain of pain on the outside border of the shoulder blade. They will also experience a deep dull ache in the shoulder.
X-rays or a sonar of the shoulder will not be of any help as it will not show anything.
How do we diagnose this condition? The patient is not able to “externally rotate the arm against resistance”, because of the concomitant weakness of the infraspinatus muscle.
Layman terms: Keep your upper arm against your body, with your elbow bent to 90°. Push the back of your fist against the wall. If you have a suprascapular nerve impingment you will not have the power to do so.
How do we treat it? Sometimes a “ganglion” might be causing the narrowing of the notch. The “ganglion can then be deflated. The radiologist will do a sonar and guide the orthopaedic surgeon to the ganglion. A needle and syringe is used to suck the fluid out of the ganglion.
If a ganglion isn’t causing the problem, the only solution is to release the narrowing around the nerve by open surgery. The strength of the muscle will return depending on how long the nerve was pinched. The pain should go away immediately after the release of the nerve.
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