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.