Compressive neuropathy of long thoracic nerve and accessory nerve secondary to heavy load bearing. A case report

Carrying heavy loads that compress the shoulders is a possible etiological factor for both accessory and long thoracic nerve entrapment. In our patient, shouldering heavy loads damaged both nerves. A 27-year-old right-hand-dominant man was referred because of difficulty in raising his arms after a brief period of painful episodes due to heavy load bearing on both shoulders. Atrophic muscles around the shoulders, depressed and winged scapula were noted. An EMG confirmed entrapment of long thoracic and accessory nerves. An exercise program was instituted; 16 months after initial referral, though winged scapula was still noted, manual muscular strength had returned without functional limitation.