Effectiveness of Combination of Ultrasonography-Guided Pulsed Radiofrequency Neuromodulation With Steroid at the Suprascapular Nerve in Chronic Shoulder Pain.

BACKGROUND

Suprascapular nerve (SSN) block is a useful tool for pain control of different chronic shoulder pain syndromes. If the short-term effect of nerve block using local anesthetics is not sufficient, pulsed radiofrequency (PRF) neuromodulation of the SSN may provide long-term pain relief.

AIM OF INVESTIGATION

The aim of this study was to determine the effectiveness of ultrasonography-guided PRF of the SSN for management of chronic shoulder pain.

SUBJECTS AND METHOD

Thirty patients with chronic shoulder pain underwent diagnostic ultrasonography-guided SSN block. After confirmation of positive results (>50% pain relief) via diagnostic testing, PRF of the SSN was performed in 27 patients, followed by application of dexamethasone; however, 2 patients had negative results with diagnostic block and 1 patient dropped out after positive results with diagnostic block. Pain was recorded using the VAS, and active range of motion of the affected shoulder was measured by goniometry (flexion, extension, adduction, abduction, external rotation, internal rotation). Assessments were done on day 0 and after 4, 8, 12, and 24 weeks.

STATISTICAL TEST

One-way analysis of variance testing.

RESULTS

The VAS score decreased significantly (P < 0.05) immediately after injection, and pain reduction was sustained for up to 24 weeks. Active range of motion in all directions also increased significantly (P < 0.5) after the procedure.

CONCLUSION

PRF of the SSN under ultrasonography guidance is a safe and effective treatment modality for management of chronic shoulder pain. The effect of a combination of PRF and a short-acting corticosteroid lasts up to 24 weeks, thereby assisting patients in undergoing relatively painless physiotherapy.