What are the symptoms of a spinal accessory nerve (SAN) injury?

Updated: Mar 04, 2020
  • Author: Rohan R Walvekar, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Shoulder pain (the most common presenting symptom)

  • Pain can radiate to the neck and upper back and occasionally to the ipsilateral arm.

  • Pain may worsen when the weight of the involved shoulder is not supported, placing strain upon the shoulder joint.

  • The etiology of pain is multifactorial and can include the straining of supporting muscles (rhomboids and levator scapulae) with subsequent traction on the brachial plexus. [2, 20]

  • Diminished strength when performing regular daily activities (eg, placing dishes in overhead shelves, exercises that involve bearing weight on the shoulders).

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