Axillary nerve dysfunction

Alternative names:

neuropathy - axillary nerve

Treatment:

Treatment is aimed at identifying the cause, treating it, and maximizing mobility and independence. In some cases, no treatment is required and recovery is spontaneous.

If there is no history of trauma to the area, conservative treatment is indicated by the sudden onset of symptoms, minimal sensation changes and no difficulty in movement, and no test evidence of nerve axon degeneration.

Corticosteroids injected into the area may reduce swelling and pressure on the axillary nerve in some cases. Systemic corticosteroids may be recommended for cases that are secondary to inflammatory lesions (such as brachial amyotrophy and brachial neuritis).

Surgical intervention is indicated if the disorder is chronic (long term) or symptoms are worsening, if there is difficulty with movement, or if there is evidence on testing that degeneration of the nerve axon is present.

Surgical exploration may be necessary to discover that the nerve dysfunction is caused by entrapment, in which case surgical decompression of the area may be of benefit.

Surgical removal of tumors (or other conditions) that press on the nerve may benefit some cases.

Over-the-counter analgesics (such as acetaminophen - oral) or prescription analgesics may be needed to control pain (neuralgia). Other medications including phenytoin, carbamazepine or tricyclic antidepressants such as amitriptyline, may be used to reduce the stabbing pains that some people experience Whenever possible, their use should be avoided or minimized to reduce the risk of side effects.

Physical therapy exercises may be appropriate for some people to maintain muscle strength.

Vocational counseling, occupational therapy, job retraining, or similar intervention may be recommended to help maximize independence.

Expectations (prognosis):

If the cause of the axillary nerve dysfunction can be identified and successfully treated, there is a possibility of full recovery. The extent of disability varies. The worst problem most often is shoulder weakness.

Complications:

• partial or complete arm paralysis
• partial or complete loss of sensation in the arm (uncommon)
• recurrent or unnoticed injury to the arm
• deformity of the arm, shoulder contracture or fibrosis ("frozen shoulder")

Calling your health care provider:

Call for an appointment with your health care provider if symptoms of axillary nerve dysfunction are present. Early diagnosis and treatment increase the chance of controlling symptoms.