Entrapment of the dorsal scapular nerve (DSN) is an under-recognized cause of neck, upper back, and scapular pain. Symptoms are often similar to other conditions and can be mistaken for rib pain, cervical disc herniation, or shoulder pathology.
The course of the DSN begins at the neck going through the scalene muscles, then passes under the levator scapulae and rhomboids as it runs down the inside border of the scapula.
As it travels along this path, there are many places where it can get trapped. The scalenes, levator scap, and rhomboids are all potential places where this can occur. Entrapment at the scalene musculature is most commonly seen, even if a person isn’t experiencing any neck pain.
Typically, a person will complain of pain down the inside border of the scapula on one side, pain across the shoulder blades, lower neck, shoulder, and/or arm pain. It often feels like burning, sharp, stabbing, shooting, or knife-like pain and may feel like it’s actually underneath the shoulder blade.
A lot of overhead activity, reaching out in front of the body, or slouched sitting can all cause this condition to develop. When DSN entrapment is present, aggravating factors may include turning the head to the side of pain, extending the head backward, sleeping on the stomach with head towards the side of pain, and prolonged sitting.
Dr. Ryan Donahue was born and raised in Sioux City, IA. He attended the University of Iowa where he received a bachelor’s degree in Health and Human Physiology before graduating Magna Cum Laude from Northwestern Health Sciences University as a Doctor of Chiropractic. Dr. Donahue is a Certified Provider of Active Release Technique, RockTape kinesiology tape, and SMART Tools (Instrument Assisted Soft Tissue Mobilization). He has also had extensive post graduate training in various treatment and rehabilitation approaches that include McKenzie Mechanical Diagnosis and Therapy and Dynamic Neuromuscular Stabilization (DNS).