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Alternative Names Return to topNeuropathy - axillary nerve
Definition Return to top
Axillary nerve dysfunction is a loss of movement or sensation of the shoulder because of nerve damage.
Causes Return to top
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. A problem with just one nerve group, such as the axillary nerve, is called mononeuropathy.
The usual causes include direct trauma, prolonged pressure on the nerve, and compression of the nerve from nearby body structures. Entrapment involves pressure on the nerve where it passes through a narrow structure.
The damage may include destruction of the myelin sheath of the nerve or destruction of part of the nerve cell (the axon). Damage to the axon slows or prevents conduction of impulses through the nerve.
Direct injury to the shoulder and pressure on the nerve can lead to axillary nerve dysfunction.
Conditions associated with axillary nerve dysfunction include:
In some cases, no cause can be identified.
Symptoms Return to top
Exams and Tests Return to top
Your health care provider will examine the arm and shoulder. There may be weakness of the shoulder with difficulty moving the arm.
The deltoid muscle of the shoulder may show signs of muscle atrophy.
Tests that reveal axillary nerve dysfunction may include:
Treatment Return to top
Some people do not need treatment, and they get better on their own but the rate of recovery is variable and can take many months.
Anti-inflammatory medications may be given if you have sudden symptoms, little sensation or movement changes, no history of injury to the area, and no signs of nerve damage. These medicines reduce swelling and pressure on the nerve. They may be injected directly into the area or taken by mouth.
You may need over-the-counter or prescription pain medicines to control pain. If you have stabbing pains, your doctor may prescribe other medications, such as carbamazepine, gabapentin, or certain tricyclic antidepressants such as amitriptyline or nortriptyline.
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.
Outlook (Prognosis) Return to top
It may be possible to make a full recovery if the cause of the axillary nerve dysfunction can be identified and successfully treated.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
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 Return to top
Preventative measures vary, depending on the cause. Avoid prolonged pressure on the underarm area. Examine casts, splints, and other appliances for proper fit. Crutch training should include instructions not to place pressure on the underarm.
References Return to top
Pryse-Phillips W, Murray T. Peripheral neuropathies. In: Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001:chap 167.Update Date: 3/26/2009 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.