Scapular pain in cervical radiculopathy: A scoping review

Abstract

Background: Controversy persists regarding the relationship between scapular pain and cervical radiculopathy, with no consensus on cervical radiculopathy’s definition, radicular pain distribution, or the diagnostic value of scapular pain. This review aims to map the literature describing scapular pain distribution in cervical radiculopathy in clinical practice and research. Methods: This scoping review followed JBI methodology, guided by the PRISMA-ScR extension. Studies reporting on cervical radiculopathies with described radicular pain distribution were included. Exclusions applied to radicular pain from peripheral neuropathy, fracture, cancer, rheumatologic, or vascular disorders, and inadequately described scapular pain. Information sources included Ovid MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL. JBI methodology was followed, guided by the PRISMA-ScR extension. Pain distributions were mapped by region, cervical nerve root level, and diagnostic confirmation methods. Results: The review included 86 studies (1957–2022). Among the 81 studies describing pain distribution, neck (88%), arm (85%), and scapula (72%) were most frequently reported. Of 60 studies documenting pain by nerve root level, C6 (82%), C7 (77%), and C8 (63%) were most common, with C7 showing the highest percentage of scapular pain descriptions. Evidence indicates scapular pain may precede arm pain by several weeks in cervical radiculopathy. Conclusions: Evidence supports scapular pain as a symptom of cervical radiculopathy, potentially preceding arm pain by weeks. Future studies should document symptoms at onset, define radicular pain distributions, include participants with scapular pain, and assess the diagnostic utility of scapular pain in cervical radiculopathy