When talking about the suprascapular nerve, we need to understand the brachial plexus nerve. The brachial plexus nerve is located in the neck and innervates the upper extremities as well as the ipsilateral upper chest. The brachial plexus nerve originates from the C5-T1 region, and the C5/C6 merge into a bundle called the superior bundle. The suprascapular nerve originates from this bundle. The suprascapular plexus passes under the oblique muscle, turns to the superior border of the scapula, and then divides obliquely laterally into the suprascapular muscle. After entering the muscle, it then divides into 1 more branch into the subscapularis muscle. Any injury to the nerve may cause paralysis. The 3 most common causes are: 1. Nerve entrapment (suprascapular notch or glenoid notch of the scapular joint): cysts around the glenoid labrum, osteophytes; 2. Larger trauma or repeated trauma: scapular fractures, rotator cuff tears, shoulder immobilization, etc. can cause nerve compression. Repeated trauma is more common in some repeated over the top athletes, such as tennis Repeated trauma is more common in some athletes who repeatedly perform over the top, such as tennis, weightlifting, boxing, softball, etc.; 3. Neuralgic myasthenia gravis: Rarely, it can cause acute shoulder pain and muscle weakness, and some studies suggest that it is related to CMV virus infection. Once the damage to the suprascapular nerve is caused, then the muscles it innervates will show symptoms of nerve paralysis. Presentation, symptoms and diagnosis The suprascapularis nerve innervates the suprascapularis and subscapularis muscles, which are part of the rotator cuff and help to lift the shoulder joint. If the suprascapularis is affected, abduction of the shoulder joint is limited, and if the subscapularis is damaged, internal rotation is limited. Muscle atrophy is easy to detect and can be seen as a distinct difference when viewed from behind. The degree of pain varies from person to person, sometimes it is mainly impingement-induced pain, while other times it is mainly pain around the shoulder joint (not clearly localized), which worsens with activity. Neuromuscular atrophy, on the other hand, presents early on with severe pain radiating to the back, neck and upper chest. Diagnosis can be made by EMG testing, and MRI can assist in the diagnosis and clarify the presence or absence of periglenoid labral cysts. However, a detailed history and physical examination are often required for diagnosis. MRI suggests suprascapular atrophy, fatty infiltration, and the suprascapular nerve beneath it Treatment: Physical therapy is the initial treatment, allowing the nerve to slowly recover through specific rehab exercises to avoid movements that may aggravate the injury. If conservative treatment is not effective, then surgical intervention may be required. Your possible concerns: Pain: Nerve block anesthesia is generally not used because it may interfere with nerve detection. Pain medication will be given on a regular basis for over-the-top analgesia during your hospital stay and will continue to be required until after you are discharged. The use of ice packs on the painful area may also provide pain relief. Wound: With minimally invasive arthroscopic surgery, there are only 3-4 incisions of about 5 mm, compared to about 10 cm for open surgery, and the wound will be covered with an adjuvant to minimize infection as well as bleeding. This is usually removed 5-7 days after surgery. Brace: A brace is required after surgery and is usually worn at night while sleeping. Driving: Generally, you can start driving about 1 week after surgery, but for your safety, it is still recommended that you do not drive until you feel well again. Return to work: Depending on the nature of your work, 1 week after surgery is sufficient for clerical work, but for physical work with a lot of overhead movements, it is generally recommended that you take a long enough break before working again. Recreational activities: Avoid overhead movements for 3 months, if you want to swim, it is recommended to start with breaststroke. 6 weeks or so you can start golfing. Some other exercises may vary depending on the individual, consult your rehabilitation physician for details. Follow-up: Please see us again 3 weeks after surgery for an evaluation of the efficacy of the surgery and rehabilitation. Prognosis: It varies from person to person. In our experience, elevation to shoulder level can be performed 3 weeks after surgery, at which time you can perform shoulder mobility exercises. Physiotherapy: Physiotherapy is performed as early as possible after surgery to control pain, promote mobility recovery and muscle strength recovery. It is best to have a professional rehabilitation physician to follow up your post-operative progress so as to help you recover early.