Winging of the scapula due to long thoracic nerve palsy is a common diagnosis and should be treated as a significant functional problem. It must be recognized that scapular winging is not simply an aesthetic issue; the compensatory muscular activity required to improve shoulder stability is associated with secondary pain and spasm due to muscle imbalances and tendonitis around the shoulder joint.

Surgical decompression and neurolysis appears to be an effective and rational treatment modality in specific instances where supraclavicular injury to the long thoracic nerve is identified. Risk factors for supraclavicular nerve injury include a history of vigorous athletic maneuvers with the affected extremity, lifting of heavy weights, and direct external pressure.

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Dear Dr. Nath,

I've had the best week I've had in almost 2 1/2 years! I'm teaching a full schedule, SINGING again (booked into May, 2005!) and even socializing and walking some again. Best of all, I can manage this activity with very little pain medication. I'm using a TENS unit several hours daily as you suggested and it really helps, whereas before my surgery, electrical stimulation provoked pain. Find out more

Hello Dr. Nath,

My husband and I are so thrilled with the results from my surgery last week. We're still in shock that I can actually use my arm/shoulder to complete everyday activities, like blowing drying my hair, without repositioning my body to compensate for the winging scapula. I truly appreciate everything that you've done for me. Find out more