Axillary nerve palsy is a well-recognized complication of shoulder dislocation. Axillary nerve palsy is a condition characterized by loss of movement or sensation in the shoulder area. Axillary nerve palsy may occur in the myelin sheath (which shelters and protects the nerve) or the central part of the nerve cell (known as the axon). Any damage to these areas diminishes or inhibits the movement of impulses within the nerve.
There are several reasons axillary nerve palsy occurs, but the prominent reason for its occurrence is a shoulder dislocation. Another reason could be excess stress or damage to the axillary nerve, which serves the deltoid muscles and the skin of the shoulder.
Axillary nerve palsy symptoms vary in patients. Some patients may complain of not being able to bend the arm at the elbow only, with no other axillary nerve palsy symptoms.
Axillary nerve palsy diagnosis is further complicated, due to delayed onset. It may even go unnoticed for one to two years post shoulder dislocation. Therefore, for correct axillary nerve palsy diagnosis, it is important to understand the symptoms and the fact that it differs in people.
Axillary nerve palsy diagnosis
Axillary nerve palsy diagnosis can be carried out with the following investigations:
Axillary nerve palsy treatment
Normally, recovery happens spontaneously, no treatment is required. For mild to moderate axillary nerve palsy, physical therapy and changes to a daily routine may be just fine. Specific exercises can also help the muscle groups improve nerve damage and preserve nerve function.
In cases of swelling and inflammation around the axillary nerve area, anti-inflammatory medications may be prescribed to combat their effects, which may be putting pressure on the axillary nerve. It can be said that in the majority of cases, effective medical treatment is enough to cure axillary nerve palsy. The outcome, however, depends on the extent and nature of the nerve damage that occurs. At times and trapped nerve may need
However, surgery may be required, sometimes, to restore the normal functions of the axillary nerve, especially when it’s trapped. Surgery is usually considered if there is no natural restoration of the nerve function after six months of treatment. Some of the surgery that may be carried out include nerve grafting, neurolysis, or nerve reconstruction.
- Physical examination of the shoulder to look out for pain sensitivity, movement sharpness and swelling.
- Medical review.
- Your doctor may recommend certain tests such as
- Electromyography (EMG) to check the status of the axillary nerve.
- MRI and X-ray.
The following are axillary nerve palsy symptoms:
- Feeling numbness or tingling in the shoulder region.
- Weakness in the shoulders.
- Problems with normal physical activities; for instance, lifting the arms above the head.
- Having difficulty lifting objects.
- Reduced volume of shoulder muscles.
The possible axillary nerve palsy causes include:
- Blunt trauma or excessive stress on the axillary nerve over a long period.
- Other body parts putting pressure on the axillary nerve or trapping the nerve against other body structures.
- A penetrating injury, like a knife, machete or gunshot wound.
- Exceeding the normal range of motion or hyperextension injury.
What is the long term outlook for axillary nerve palsy?
In most cases, effective treatment is more than enough to cure axillary nerve palsy. The outcome, however, depends on the extent and nature of the initial injury.
A trapped nerve may lead to chronic pain, but this resolves after surgery is done.
Those caused by long-term stress respond well to anti-inflammatory medications and physical therapy.
Who are those at risk of axillary nerve palsy?
You may be at risk of axillary nerve palsy if:
- You are an athlete or someone who participates in high-impact activities that involves the upper part of the body.
- You perform repetitive tasks that involves the shoulder.
- You have an existing bone fracture.
- You improperly use supportive equipment like crutches.