Objective: The purpose of this case series is to describe the diagnosis and management of dorsal scapular nerve neuralgia in two patients. Both patients presented uniquely by having full strength of their rhomboids and levator scapula, and had a chief complaint of burning and tingling along the medial scapular border.
Clinical Features: Two patients presented with a chief complaint of paresthesia in the dorsal scapular nerve distribution. While the differential diagnosis included dorsal scapular nerve entrapment and notalgia paresthetica, these cases show the efficacy of treating without the use of advanced imaging techniques, nerve blocks, and/or electrodiagnostic studies.
Interventions and Outcomes: Both patients received chiropractic manipulation to their cervical and/or thoracic joints, had skin rolling performed over the distribution of the dorsal scapular nerve, and post-isometric relaxation (PIR) performed on the posterior and/or middle scalene muscles. Both patients had complete resolution of the presenting complaints at follow up.
Conclusion: Chiropractic care, including spinal adjustments, skin rolling, and PIR may be beneficial for patients with dorsal scapular nerve entrapments. While confirming a diagnosis may require advanced imaging, nerve blocks, and electrodiagnostics, it may not be needed to treat a patient successfully.
Key Words: Dorsal Scapular Nerve; Chiropractic
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