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There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]
Sensation, including pain and the sense of joint position (proprioception), travel via the ventral rami of the third (C3) and fourth (C4) cervical spinal nerves. [5] Since it is a muscle of the upper limb, the trapezius is not innervated by dorsal rami, despite being placed superficially in the back.
Injury to the accessory nerve can result in neck pain and weakness of the trapezius muscle. Symptoms will depend on at what point along its length the nerve was severed. [ 5 ] Injury to the nerve can result in shoulder girdle depression, atrophy, abnormal movement, a protruding scapula, and weakened abduction . [ 5 ]
Palpation of the trigger point reproduces the patient's complaint of pain, and the pain radiates in a distribution of the muscle and/or nerve. Patients can have a trigger point in their upper trapezius and when compressed feel pain in their forearm, hand and fingers (S. Goldfinch)
Symptoms include overuse muscle pain and fatigue along the back of the neck and reaching down to the mid-back, often starting with the upper trapezius muscle bellies between the shoulders and neck. Cervicogenic headache from the joints and muscle attachments at the top of the neck is common. [12] [13]
Tender points: [1] While medical doctors use eleven of eighteen tender points as a diagnostic criteria for fibromyalgia, Sarno states that he uses six main tender points to diagnose TMS: two tender points in the upper trapezius muscles, two in the lumbar paraspinal muscles and two in the lateral upper buttocks. He states that these are found in ...
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