Disease

Axillary nerve dysfunction

Definition

Axillary nerve dysfunction is nerve damage that leads to a loss of movement or sensation in the shoulder.

Alternative Names

Neuropathy - axillary nerve

Causes, incidence, and risk factors

Axillary nerve dysfunction is a form of peripheral neuropathy. It occurs when there is damage to the axillary nerve, which supplies the deltoid muscles of the shoulder and the skin around it. A problem with just one nerve, such as the axillary nerve, is called mononeuropathy.The usual causes are:Direct traumaLong-term pressure on the nervePressure on the nerve from nearby body structuresShoulder injuryEntrapment creates pressure on the nerve where it passes through a narrow structure.The damage may destroy the myelin sheath that covers the nerve, or part of the nerve cell (the axon). Damage of either type reduces or prevents the movement of impulses through the nerve.Conditions that can lead to axillary nerve dysfunction include:Body-wide (systemic) disorders that cause nerve inflammationDeep infectionFracture of the upper arm bone (humerus)Pressure from casts or splintsImproper use of crutchesShoulder dislocationIn some cases, no cause can be found.

Symptoms

Numbness over part of the outer shoulderShoulder weakness, especially when lifting the arm up and away from the body

Signs and tests

Your health care provider will examine your neck, arm, and shoulder. Weakness of the shoulder may cause difficulty moving your arm.The deltoid muscle of the shoulder may show signs of muscle atrophy.Tests that may be used to evaluate axillary nerve dysfunction include:EMG and nerve conduction tests -- will be normal right after the injury; should be performed several weeks after the injury or symptoms startMRI or x-rays of the shoulder

Treatment

Depending on the cause of the nerve disorder, some people do not need treatment. They will get better on their own. However, the rate of recovery can be different for everyone. It can take many months to recover.Anti-inflammatory medications may be given if you have:Sudden symptomsSmall changes in sensation or movementNo history of injury to the areaNo signs of nerve damageThese medicines reduce swelling and pressure on the nerve. They may be injected directly into the area or taken by mouth.Other medicines include:Over-the-counter pain medicines may be helpful for mild pain (neuralgia).Other medications (phenytoin, carbamazepine, gabapentin, pregabalin, duloxetine, or tricyclic antidepressants such as nortriptyline) may reduce the stabbing pains that some people experience.Opiate pain relievers, such as morphine or fentanyl, may be needed to control severe pain.Whenever possible, avoid or reduce medication use to lessen the risk of side effects.If your symptoms continue or get worse, you may need surgery. Surgery may be done to see if a trapped nerve is causing your symptoms. In this case, surgery to release the nerve may help you feel better.Physical therapy may help you maintain muscle strength. Job changes, muscle retraining, or other forms of therapy may be recommended.

Expectations (prognosis)

It may be possible to make a full recovery if the cause of the axillary nerve dysfunction can be identified and successfully treated.

Complications

Deformity of the arm, shoulder contracture, or frozen shoulderPartial loss of sensation in the arm (uncommon)Partial shoulder paralysisRepeated injury to the arm

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms of axillary nerve dysfunction. Early diagnosis and treatment increase the chance of controlling symptoms.

Prevention

Preventive measures vary, depending on the cause. Avoid putting pressure on the underarm area for a long period of time. Make sure casts, splints, and other appliances fit properly. When you use crutches, learn how to avoid putting pressure on the underarm.

Review Date: 2/5/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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