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What is quadrilateral space syndrome?



Quadrilateral space syndrome is the compression of a nerve and artery causing pain on moving the arm outwards (abduction) and twisting the arm outwards (external rotation). It is a rare condition that is often misdiagnosed.


What causes quadrilateral space syndrome?



The quadrilateral space is located on the outside of the shoulder at the top of the arm. It is a small space which the axillary nerve and the posterior humeral circumflex artery pass through. Quadrilateral space syndrome occurs when these structures are compressed. This can be caused by:
  • Overuse of the shoulder
  • Muscles tightening during abduction and external rotation
  • A cyst formed in relation to a labral tear
  • A tumour – this is rare
  • A haematoma – this is rare

What are the symptoms of quadrilateral space syndrome?



Quadrilateral space syndrome can cause the following symptoms:
  • Dull ache in the shoulder
  • Pain on abduction of the arm, especially when resisted
  • Pain on external rotation of the arm, especially when resisted
  • Tender to touch
  • Shoulder weakness
  • Pins and needles
  • Numbness

Physiotherapy for quadrilateral space syndrome



For most quadrilateral space syndrome cases physiotherapy can be very effective. Treatment is focused on rehabilitation and returning to normal function. Treatment may include:
  • Cold/heat therapy
  • Electrotherapy
  • Range of movement exercises
  • Stretching exercises
  • Strengthening exercises
  • Guidance on returning to functional activities

Can quadrilateral space syndrome cause any long-term effects?



In severe cases of quadrilateral space syndrome surgery is required to solve the problem. Physiotherapy is important in rehabilitation following surgery. A full recovery and a return to normal function should be made with effective treatment.

To arrange an assessment with Physio.co.uk please contact us or call 0330 088 7800.


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