Nerve injury typeConservative therapyTherapy duration and considerationsIndications for surgery
Axillary2628 Shoulder range-of-motion exercises, including posterior capsule stretching; avoid heavy lifting
For injuries associated with specific activity, assess shoulder biomechanics for that activity
Consider baseline nerve conduction studies at one month, repeat at three months
Conservative therapy for three to six months
Rare
Carpal tunnel15,25,29,30 Activity modification, splints worn at night
Consider one steroid injection
Oral steroids, yoga, ultrasound, and carpal bone mobilization have short-term benefit
Consider nerve conduction studies if no improvement within four to six weeksCommon
Consider surgery if nerve conduction studies show severe injury, thenar atrophy, motor weakness
Cubital tunnel3133 Pad external elbow against external compression; decrease repetitive elbow flexion
Extension splint (70 degrees) worn at night
Conservative therapy only for sensory symptomsOccasional
Consider surgery for motor weakness that is moderate or that does not respond to conservative therapy after three months
Poor surgical outcome for established intrinsic muscle atrophy
Interosseous nerve syndrome34,35 Cock-up splint to assist weakened wrist muscles
Avoid provocative activities
Consider elbow immobilization
Three to six monthsConsider surgery sooner if late presentation with severe weakness or atrophy, progressive weakness
Long thoracic36,37 Shoulder range-of-motion exercises to prevent contracture
Strengthen trapezius, rhomboids, and levator scapula (remaining scapular stabilizers)
Nine to 12 months is average recovery time; consider conservative treatment for up to 24 monthsRare
Pronator13,38,39 Activity modification; consider single steroid injection
Splinting with elbow at 90 degrees can be used, with monitoring for loss of range of motion at elbow
Three to six monthsOccasional
Radial tunnel38,40,41 Physical therapy for extensor-supinator muscle group
Consider single corticosteroid injection
Three months of physical therapy before consideration of surgery (unless intractable pain)Consider surgical decompression for intractable pain, although no available evidence from randomized controlled trials
Radial wrist39,42 Eliminate external compression
May consider single cortisone injection
Three monthsRare
Suprascapular4345 Physical therapy to maintain full shoulder range of motion and strengthen other shoulder (compensatory) muscles
Avoid heavy lifting and repetitive overhead activities
Early magnetic resonance imaging (at one month) to rule out anatomic lesion (i.e., ganglion cyst)
Conservative treatment for six to 12 months if no anatomic lesion
Rare unless labral ganglion cyst present
Presence of cyst indicates early consideration for surgery
Ulnar wrist39,46 Pad volar wrist area; activity modification
Splint wrist in neutral position
Six monthsRare