• LaCourt S
• Shaw T
• Carter S
• Peabody CM

• Adult
• Clavicle / injuries
• Male
• Nerve Entrapment Syndromes
• Open Access Document

Objective: Upper back pain is a prevalent complaint among young adults, with manipulation therapy demonstrating greater efficacy than nonsteroidal anti-inflammatory drugs for treatment. Clavicle fractures represent 5-10% of orthopedic fractures and have a nonunion rate of up to 30%. Nerve entrapments, particularly in young athletes, may result from such fractures. The spinal accessory nerve, which innervates the trapezius muscle, can become entrapped, leading to shoulder pain and functional limitations. There are no published reports of successful conservative management of spinal accessory nerve entrapment secondary to a clavicle malunion. This case report serves as a clinical example of a non-pharmacological, non-surgical treatment approach to spinal accessory nerve entrapment presenting with upper back pain as the primary complaint.

Clinical Features: A 21-year-old male had upper back pain, limited right shoulder motion, and mild trapezius weakness following a remote mid-clavicle fracture healed without union.

Intervention and Outcome: Chiropractic management included spinal manipulation therapy targeting cervical and thoracic spine, as well as a six-week program of therapeutic shoulder exercises. At follow-up, the patient demonstrated complete resolution of back pain and full restoration of shoulder strength and mobility.

Conclusion: This case highlights the successful use of conservative chiropractic management for spinal accessory nerve entrapment associated with a chronic, stable, clavicle malunion. The results suggest that non-surgical interventions can be a viable treatment option for spinal accessory nerve entrapments offering pain relief and functional recovery in similar cases.

Author keywords: Thoracic Spine Pain; Spinal Accessory Nerve; Clavicle Fracture; Nerve Entrapment; Chiropractic Management; Manipulation Therapy; Non-Surgical Care

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