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Axillary Nerve Injury

Axillary nerve

Injury to the Axillary nerve usually occurs as a result of a direct impact to the outer arm, although it can also be injured following a shoulder dislocation or compression of the nerve.

Symptoms of an Axillary Nerve Injury

  • Numbness over the deltoid muscle on the outer upper arm.
  • Difficulty raising the arm out to the side.
  • Wasting of the deltoid muscle in prolonged injuries.

Causes

Injury to the Axillary nerve may be due to a traumatic injury such as a shoulder dislocation or a direct impact to the outside of the upper arm. In this case, damage is done to the nerve. Either the myelin sheath (which surrounds the nerve) or the axon (the nerve itself) are injured. This may heal, or may cause a permanent disability, depending on the extent of the damage.

The Axillary nerve may also be compressed which will cause more temporary symptoms. A common example of this is the incorrect use of crutches, especially with the very old fashioned axillary crutches which apply pressure into the armpit.

Another condition to be aware of is Quadrilateral Space Syndrome. This occurs when the Axillary nerve is compressed within the quadrilateral space at the back of the shoulder. This is seen in throwers especially. As well as the symptoms listed above, the patient may complain of pain at the back of the shoulder.

Treatment

  • The patient should be referred to a neurologist.
  • An EMG may be taken to confirm the diagnosis.
  • In most cases, treatment is not necessary as the symptoms will gradually clear on their own as the nerve heals.
  • Anti-inflammatories may be prescribed to ease pain and swelling around the nerve, which helps to reduce compression.
  • Physical therapy may be recommended to maintain muscle strength as much as possible.
  • Timescales vary massively for recovery from this injury. It could be anywhere from 6 weeks to 6 months or more.
  • If symptoms do not clear or the problem gets worse, surgery may be required to further investigate the problem.
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