From the Research
Dorsal scapular nerve entrapment should be managed with ultrasound-guided hydrodissection as a first-line treatment, as it has been shown to be effective in a recent case report. This condition is characterized by pain and weakness in the rhomboid and levator scapulae muscles, often presenting as medial scapular pain and scapular winging. The symptoms can be similar to other pathologies, such as thoracic spine, costovertebral joints, facet joints, and muscle-related issues 1.
Diagnosis and Treatment
The diagnosis of dorsal scapular nerve entrapment requires careful physical examination, including assessment of scapular movement, muscle strength testing, and sometimes electrodiagnostic studies to differentiate from other neuromuscular conditions affecting the shoulder girdle. Treatment typically begins with conservative measures, including physical therapy focusing on scapular stabilization exercises, postural correction, and nerve gliding techniques. However, ultrasound-guided hydrodissection has been shown to be a successful treatment option 1.
Key Considerations
Some key considerations in the management of dorsal scapular nerve entrapment include:
- Awareness of the potential for nerve injury during trigger point injections, as reported in a case study 2
- The role of dorsal scapular nerve entrapment in unilateral interscapular pain, as highlighted in a descriptive research study 3
- The importance of proper diagnosis and treatment to prevent long-term morbidity and mortality, and to improve quality of life.
Recommendations
Ultrasound-guided hydrodissection should be considered as a first-line treatment for dorsal scapular nerve entrapment, due to its effectiveness in a recent case report 1. Additionally, conservative measures such as physical therapy and anti-inflammatory medications may be beneficial in reducing inflammation and pain. Muscle relaxants and trigger point injections may also be considered for associated muscle spasms and persistent symptoms.