Understanding Suprascapular Nerve Block and Radiofrequency Ablation: Treatments for Shoulder Pain

Shoulder pain is a common ailment that can significantly impact daily activities and quality of life. Whether caused by rotator cuff injuries, arthritis, or other conditions, persistent shoulder pain can be debilitating. Among the various treatment options available, suprascapular nerve block and pulsed radiofrequency ablation have emerged as effective methods for managing chronic shoulder pain.

What is a Suprascapular Nerve Block?

The suprascapular nerve block is a minimally invasive procedure designed to alleviate pain in the shoulder region. The suprascapular nerve, which originates from the upper trunk of the brachial plexus, provides sensory innervation to a significant portion of the shoulder. By targeting this nerve, a suprascapular nerve block can effectively reduce pain transmission from the shoulder to the brain.

How Does It Work?

During the procedure, a local anesthetic (lidocaine or bupivacaine), often combined with a steroid (cortisone, Kenalog, or dexamethasone), is injected near the suprascapular nerve. This injection temporarily blocks the transmission of pain signals, providing relief from discomfort. The procedure is typically performed under ultrasound guidance, ensuring precise placement of the needle and medication.

Applications and Benefits

A suprascapular nerve block is commonly used to manage pain associated with:

• Rotator cuff injuries: Tears or inflammation of the rotator cuff tendons can cause significant pain. A nerve block can provide relief while patients undergo physical therapy or recover from surgery.
• Arthritis: Shoulder arthritis, including osteoarthritis and rheumatoid arthritis, can lead to chronic pain. A nerve block can help manage symptoms and improve the range of motion.
• Frozen shoulder (adhesive capsulitis): This condition causes stiffness and pain in the shoulder joint. A nerve block can reduce pain and facilitate rehabilitation exercises.
• Post surgical chronic pain: Sometimes adverse events happen in operations. Nerve blocks will halt pain messages coming from the nerves in a particular part of your body to provide relief.

The primary benefits of a suprascapular nerve block include immediate pain relief, minimal side effects, and the potential to delay or avoid surgery. The effects of the block can last from several weeks to a few months, depending on the individual and the underlying condition. At this point radiofrequency ablation can be considered, which will be discussed more in the next section.

Pulse Radiofrequency Ablation: A Long-Term Solution

Pulse Radiofrequency ablation (RFA) is another minimally invasive procedure that offers a longer-lasting solution for chronic shoulder pain. This technique uses radiofrequency energy to change the way nerves transmit pain signals.

How Does It Work?

In a pulse RFA procedure, a thin needle is inserted into the target area near the affected nerves. Unlike RFA, pulsed radiofrequency does not burn away the nerve. It only changes the way it transmits pain signals. Like the suprascapular nerve block, pulse RFA is typically performed under imaging guidance to ensure accuracy.

Applications and Benefits

Radiofrequency ablation is particularly useful for patients with:

• Chronic shoulder pain: Especially when other treatments, such as physical therapy, medications, or injections, have been ineffective.
• Shoulder arthritis: Pulse RFA can provide long-term pain relief for patients with arthritis who are not candidates for surgery.
• Persistent pain following shoulder surgery: For patients experiencing continued pain after surgical interventions, pulse RFA can be a viable alternative.

The primary advantages of pulse RFA include prolonged pain relief, often lasting six months to a year or longer. Additionally, the procedure has a low risk of complications, a short recovery time, and can be repeated if necessary.

Pre-Procedure Information

Consultation and Evaluation

Before undergoing a suprascapular nerve block or radiofrequency ablation, you’ll have a consultation with a pain management specialist or a healthcare provider. During this visit, they will:

• Review your medical history: This includes past surgeries, existing medical conditions, and any medications you’re currently taking.
• Perform a physical examination: The doctor will assess your shoulder’s range of motion, strength, and pain levels.
• Order diagnostic tests: Imaging studies like X-rays, MRI, or ultrasound may be recommended to better understand the source of your pain.

Pre-Procedure Instructions

To ensure the procedures are safe and effective, follow these general guidelines:

• Medications: Inform your doctor about all medications and supplements you take. You may need to stop taking certain medications, such as blood thinners, for a specified period before the procedure.
• Fasting: You may be instructed to avoid eating or drinking for several hours before the procedure, especially if sedation or anesthesia is involved.
• Transportation: Arrange for someone to drive you home, as you may not be able to do so safely after the procedure.
• Clothing: Wear loose, comfortable clothing, and avoid jewelry or accessories that might interfere with the procedure.

Post-Procedure Information

Immediate Aftercare

• Observation: You may be monitored for a short time to ensure there are no immediate complications, such as allergic reactions or excessive numbness.
• Pain and Discomfort: It’s normal to experience some soreness at the injection site. This usually resolves within a few days.
• Activity: Limit physical activity for the first 24 hours. Avoid heavy lifting, strenuous exercise, or any movements that could strain your shoulder.

Recovery and Follow-Up

• Pain Relief: Pain relief from a suprascapular nerve block may be immediate, but the full effects of pulse RFA may take a few days to manifest as the targeted nerves become less responsive to pain signals.
• Side Effects: Possible side effects include temporary weakness, numbness, or a slight increase in pain before relief sets in. Report any unusual symptoms to your doctor.
• Medications: Your healthcare provider may prescribe pain relief medications or advise over-the-counter options to manage discomfort.
• Physical Therapy: Depending on your condition, you may be referred to a physical therapist to aid in rehabilitation and strengthen the shoulder muscles.

Suprascapular nerve block and pulsed radiofrequency ablation are valuable tools in the management of chronic shoulder pain. These procedures offer hope for those who have not found relief through conventional treatments, providing both immediate and long-term solutions. As with any medical intervention, it’s essential to consult with a healthcare provider to determine the most appropriate treatment plan tailored to individual needs. Need help with managing pain? Get in touch with us today.

The information provided on this website is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.