A direct branch of the upper trunk of the brachial plexus (C4–6)
Crosses the posterior neck, under the trapezius, travels under the transverse scapular ligament through the suprascapular foramen across the spine of the scapula and then through the spinoglenoid notch
Cutaneous innervation of the lateral superior shoulder
Supraspinatus: Abducts the humerus; especially the initial 20–30 degrees
Infraspinatus: Externally rotates the humerus
The suprascapular artery most commonly passes superficial to the ligament. The SN (stemming from the ventral rami of spinal nerves C4, C5, and C6 and emerging from the upper trunk of the brachial plexus) provides 70% of sensory innervation to the shoulder joint.
Pathophysiology and Clinical Presentation
Differential diagnosis for suprascapular nerve-related shoulder pain
Ganglion cyst at the suprascapular notch
Ganglion cyst at the spinoglenoid notch
SLAP lesion (Superior labrum anterior-posterior tear)
Adhesive capsulitis and osteoarthritis
Poststroke shoulder pain
Diagnostic criteria for suprascapular nerve neuropathy
Atrophy of supraspinatus and infraspinatus muscles
Weakness with abduction/external rotation.
Possible edema of the corresponding muscle or direct compression of nerve by a cyst
EMG showing axonal loss limited to SN distribution
Motor NCVs showing reduced amplitude
Edema, atrophy, or fatty infiltration of supraspinatus or infraspinatus muscles
A suprascapular nerve block (SNB) is used for perioperative and postoperative pain control after surgery. The block can also be utilized for chronic pain management and diagnostic purposes for shoulder pain. Pulsed radiofrequency of the suprascapular nerve in conjunction with physical therapy has been shown to accelerate the recovery from adhesive capsulitis.