Spinal Accessory Neuropathy Associated With Deep Tissue Massage: A Case Report

Scapular Winging

“…It is easy to rationalize the damage caused to the nerve from an acute traumatic event such as direct blow in a road traffic collision with acute onset of scapular winging, or iatrogenic damage from needle thoracocentesis [11,41]. The mechanism of nerve injury from repetitive minor trauma where no specific event can be identified is more difficult to appreciate, yet this supposed aetiology is more common across the literature [4,21,30,[42][43][44][45][46]41]. In this scenario with no clear acute traumatic event, the classic presentation is of an initial onset of severe pain, which subsides over a period of approximately 2 weeks before the weakness and scapular winging becomes apparent.…”

“…Apart from lesions to the long thoracic nerve, rare cases of scapular winging from traumatic avulsion of the serratus anterior or displaced inferior pole scapular fractures have been described [28,29]. EMG is valuable in demonstrating isolated long thoracic nerve injury as the cause rather than the aforementioned traumatic avulsion or secondary winging from another cause [10,23,[29][30][31].…”

“…The nerve then runs alongside the internal jugular vein and crosses it laterally to pierce and innervate sternocleidomastoid. It then enters the posterior triangle of the neck, covered only by skin and subcutaneous fascia, to supply trapezius [5,30,42,66].…”

Acute Radial Neuropathy at the Spiral Groove Following Massage: A Case Presentation

“…In a review of the literature, various massage‐related complications have been reported, including hematomas, pulmonary emboli, rupture of the uterus, and ulceration with infection [4]. However, only 5 cases have been reported with arm nerve injuries following massage, including injuries to the posterior interosseous nerve, recurrent motor branch of median nerve, spinal accessory nerve, and brachial plexus [2,3,5‐7].…”

Analysis of clinical and neurological outcomes in patients with cauda equina syndrome caused by acute lumbar disc herniation: a retrospective-prospective study

“…Up to now, spinal massage has already been repeatedly reported regarding serious adverse events it leads to [ 11 – 18 ]. Massage may result in acute spinal subdural hematoma [ 12 ], cervical hematomyelia [ 13 ], subcutaneous hematoma [ 14 ], spinal accessory neuropathy [ 16 ], lumbar epidural hematoma [ 17 ]; but most are CES [ 15 , 17 , 18 ]. Data from those reports indicate that massage may be associated with mild and transient adverse events, but sometimes it may be indeed associated with some serious complications leading to permanent disability, or even death.…”