When the cause of a patient’s pain is due to entrapment of the dorsal scapular nerve (DSN), determining where it’s getting trapped will help guide treatment and in giving the proper home exercises.
The DSN may be getting caught up in one area, or multiple areas because of muscular tension, poor posture, or both. Whatever the case may be, treatment that includes a variety of techniques will provide the most successful outcomes.
Adhesions develop within the musculature and other soft tissues in the area making it difficult for the DSN to move freely with neck and shoulder movements. Pain develops when the tension and adhesions get to the point that it’s trapping the nerve.
Active Release Technique has proven to be a very effective treatment method in breaking up those adhesions and trigger points around the neck and shoulder blade.
While the entrapment most commonly occurs at the neck, treatment must also include looking at scapular movement when going through shoulder ranges of motion. Since the DSN runs so close to the shoulder blade, it can sometimes get ‘attached’ to it with reaching and overhead movements.
When this happens, the nerve is placed under more strain and can aggravate the symptoms. Making sure these two structures are able to move independent of one another is important for long-term success.
Finally, manipulation of joints in the neck and mid back may be a part of treatment in-office. If indicated, this will help the joints move freely through pain free ranges of motion.
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).