Your spinal accessory nerve is located on either side of your neck just under the surface of your skin. This nerve innervates your trapezius muscle, located between your shoulders and your neck, and is responsible for shoulder stability and elevation. Your spinal accessory nerve can be damaged when you suffer a neck injury. Damage to this nerve can result in numbness, weakness, and pain in your shoulder or arm on the either the left or right side of your body. In severe cases, surgery may be required to repair your accessory nerve.
Inflammation Control
Inflammation and swelling occur after an injury to the soft tissues surrounding your spinal accessory nerve, including tendons, muscles and ligaments. When inflammation and swelling are present, healing in your shoulder and neck area cannot begin. Controlling inflammation with ice and medication is the first step in physical therapy for repairing spinal accessory nerve damage. Ice your neck and shoulder for 20 minutes at a time, several times a day. Your physician may also prescribe anti-inflammatory medications to further control inflammation and swelling in your neck and shoulder.
Muscle Strengthening
Your spinal accessory nerve sends signals to the muscles of your shoulder and arm, signaling them to contract. When your spinal accessory nerve is damaged, this signal can be disrupted and result in muscle weakness. Your physical therapist may prescribe muscle-strengthening exercises to rebuild muscle that has been weakened by your spinal accessory nerve damage. These exercises may include resistance training with equipment such as resistance bands, free weights or weight-training machines. The therapist will assist you in regaining strength and control in your affected arm and shoulder.
Motor Control
Your spinal accessory nerve is responsible for fine motor control, specifically in the trapezius and sternocleidomastoid muscles of your neck. These muscles are important for shoulder and neck mobility. Your physical therapist may prescribe a series of exercises that require you to isolate these muscles in such a way to stimulate your spinal accessory nerve. These exercises may include turning your head from side to side with resistance, or elevating your shoulders while holding on to a weight.
Range of Motion
Injury to your spinal accessory nerve can affect your range of motion and flexibility in the joints around your shoulder and neck. A loss of range of motion in these areas can lead to stiffness, and pain and can adversely affect your ability to perform every day activities. Your physical therapist may provide you with a series of stretching and flexibility exercises to increase the range of motion in your shoulder and neck. These exercises will stretch the tendons and ligaments that support your shoulder and neck so that they become more elastic and less constricting.
References
- NYU Medical Center; Spinal Accessory Nerve Injury
- "Introduction To Physical Therapy"; Michael A. Pagliarulo; 2011
