Dorsal Scapular Nerve
Dorsal scapular nerve entrapment was first reported in applied kinesiology in 1981.4 Since then advances in applied kinesiology have shown increasing integration of this entrapment with other conditions such as the anterior cervical subluxation (hidden cervical disc) and suprascapular nerve entrapment.
The dorsal scapular nerve arises predominately from the 5th cervical nerve and may receive contribution from C4 and C6. The nerve is purely motor, with no sensory fibers. It enters the interscalene triangle and almost immediately pierces the scalenus medius muscle, running dorsally and caudally to supply the rhomboid major and minor muscles and a portion of the levator scapula. The levator scapula receives additional nerve supply from the 3rd and 4th cervical nerves.
Symptoms:1, 2
Entrapment of this nerve by the scalenus medius muscle usually involves pain along the medial border of the scapula, radiating into the lateral surface of the arm and forearm. The pain is a generalized dull ache, characteristic of a motor nerve.
There may be no historical event the patient can recall for the cause of his pain, but usually there is trauma or occupational etiology. The most common is trauma to the scalene muscles by violent stretching such as cervical hyperextension-hyperflexion of whiplash dynamics.
Occupations that require extended overhead work, such as painters and electricians, make workers susceptible to develop dorsal scapular nerve entrapment. In this case the patient’s symptoms develop in association with the work position.