This post is about Shoulder Pain and Long Thoracic Nerve Injury: Chiropractic Treatment Can Help.  Symptoms include pain or discomfort in the shoulder, neck, mid back and scapular region.  Also, weakness can be present in the same areas. Moreover, winging of the scapula medially (towards mid line) can also occur.

Your shoulder elevation will be limited and the scapulohumeral rhythm (coordinated motion of the scapula and humerus experienced during shoulder movement) will be altered.Your shoulder may be painful for days to weeks as in neuritis (inflamed nerve).  And/or it may be subtle as in feeling pressure from a chair/object against the winged scapula. Additionally, winging may not be obvious until several weeks after acute injury.

 If you have pain due to Long Thoracic Nerve Injury, chiropractic treatment may be your best choice for relief! 

About the Long Thoracic Nerve

Firstly, the long thoracic nerve forms directly from the cervical (neck) spinal nerves root of C5, C6, and C7. Secondly, it is a pure motor nerve (carries signals to your muscles to help you move) that innervates only the serratus anterior muscle. Thirdly, the long thoracic nerve passes through the middle scalene muscle (1 of 3 muscles found on each side of the neck, spanning between the neck and the upper two ribs).  Fourthly, the nerve goes under the brachial plexus (network of nerves in the shoulder) and over the first rib. Finally, it continues on and innervates the serratus anterior muscle.

What Causes Long Thoracic Nerve Injury?

Long Thoracic Nerve Injury may result from nontraumatic causes such as a virus or autoimmune disease.  However, it can definitely occur from traumatic overstretching between the head and the shoulder.   For instance, during an athletic manuever or a football game where there is trauma to the lateral rib age or between the clavicle and the second rib.  Furthermore, repetitive arm abduction (moving arm away from mid line of body) or backward arm extension in the swimmer’s backstroke, backpacking, or shoveling can injure this nerve.  And heavy weight lifting or back packs are also possible causes. Prolonged recumbency (resting/reclining) during surgery can also be the culprit. Lastly, injury may occur with nerve damage (whiplash) during a motor vehicle accident.


“Winging” of the Scapula (Shoulder Blade)

Winging causes the scapula to stick outwards and upwards. This causes the shoulder blade to resemble a “wing”. So when muscles weaken and fail to hold the scapula close against the back of the rib cage, winging happens.

In Long Thoracic Nerve injury, this nerve innervating (to supply with nerves) the serratus anterior muscle is damaged.  In turn, the serratus anterior muscle cannot stabilize the scapula during shoulder abduction (arm movement away from the middle of your body).

The serratus anterior muscle is a prime mover in both scapular protraction (moving forward) and scapular upward rotation.  Therefore, there is winging of the scapula and difficulty with overhead motions and forward elevation of the shoulder when this muscle is weakened/dysfunctional.


Diagnosis of a long thoracic nerve injury is made by your doctor during the examination with inspection and tests. Plain X-rays and magnetic resonance imaging (MRI) does not reveal long thoracic nerve injury.  An electromyographic (EMG) and a nerve conduction velocity (NCV) test(s) may be ordered later to examine the function of the long thoracic nerve, but not necessary to start chiropractic treatment.


Treatment at Meiri Chiropractic in West Palm Beach


Chiropractic manipulative treatment/therapy to the spine and extremities (e.g. limbs) are effective for Long Thoracic Nerve Injury. Our other therapies, such as soft tissue techniques, electric muscle stimulation, ice/ heat therapies and homeopathic consultations provide relief.  Through regular chiropractic visits, you can get pain relief and improve your health without drugs or surgery!


At Meiri Chiropractic we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have.  Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition.  We have been offering effective chiropractic care in West Palm Beach since 2006.  Many of our patient reviews note our excellence.  Call us today at 561-253-8984 to make an appointment or to find out more about Shoulder Pain and Long Thoracic Nerve Injury: Chiropractic Treatment Can Help.