Effects of ultrasound-guided suprascapular nerve pulsed radiofrequency on chronic shoulder pain

Abstract

Aim: Pulsed radiofrequency (PRF) therapy has become increasingly popular in the treatment of chronic shoulder pain due to its long duration of action and non-destructive method. The aim of the study was to reveal the effects of PRF therapy of the suprascapular nerve (SSN) under ultrasound guidance (UG) in patients with chronic shoulder pain on both shoulder pain and function.Material and methods: This study included 74 patients diagnosed with at least one of the following: adhesive capsulitis, rotator cuff syndrome and impingement syndrome of shoulder. The PRF therapy of the SSN under UG was performed in those patients with a reduction of 50% or more Visual Analog Scale (VAS) score and those that reported healing in the active range of motion (AROM) in the diagnostic SSN block. The resting, motion and sleeping shoulder pain assessments of the patients were done with VAS score. The shoulder joint function was assessed with the Shoulder Pain and Disability Index (SPADI) questionnaire and the AROM of the joint was measured using a goniometer.Results: In 70 of the 74 patients a 50% or more reduction was found in the VAS score with diagnostic SSN block. After the PRF therapy of the SSN, the 15thday, 1st month, 3rd month, and 6th month follow-up VAS averages, SPADI averages and the flexion, internal rotation, external rotation, and abduction values were statistically significantly lower than the baseline values (p<0.05).Conclusion: This study is the largest series in the literature evaluating the efficacy of PRF therapy of the SSN under UG and has shown that pain canbe controlled quickly, for a long period of time, using ultrasound guided PRF therapy of the SSN in chronic shoulder pain.

A systematic review and meta‐analysis of radiofrequency procedures on innervation to the shoulder joint for relieving chronic pain

“…Taverner & Loughnan, 2014;Wu et al, 2014;Yan & Zhang, 2019) and one was a retrospective study in which pRF and injection of LA on the SSN were offered to both the groups with steroids being injected in one group (Gabrhelik et al, 2010) (Table 1). There were 11 prospective case series (Bone et al, 2013;Brown et al, 1988;Ergonenc & Beyaz, 2018;Gurbet et al, 2005;Jang et al, 2013;Kane et al, 2008;Keskinbora & Aydinli, 2009;Liliang et al, 2009;Luleci et al, 2011;Shabat et al, 2013;Sinha et al, 2020) Simopoulos et al, 2012;Sir & Eksert, 2019;Taverner et al, 2013) and eight case reports (Eckmann et al, 2019;Hackworth, 2013;Huang et al, 2010;Kim et al, 2012;Lipov et al, 2013;Ozyuvaci et al, 2011;Shah & Racz, 2003;Sluijter et al, 2008) (Table 2). In all, 36 of these publications were on pRF procedures and 29 of these publications reported procedures exclusively done on the suprascapular nerve.…”

“…Bone and colleagues performed SSN block with LA and steroid for all except three patients and Chang and colleagues injected only LA in all patients in their series and they mandated 50% or greater reduction in intensity of pain before proceeding with aRF. Prognostication blocks were performed in nine of the studies involving pRF (Ergonenc & Beyaz, 2018;Hackworth, 2013;C. C. Huang et al, 2010;Jang et al, 2013;Keskinbora & Aydinli, 2009;Kim et al, 2012;Liliang et al, 2009;Shah & Racz, 2003;Sinha et al, 2020).…”

“…These instruments were either self-reported by patients or applied during assessments by clinicians. The Shoulder Pain and Disability Index (SPADI) (Ergonenc & Beyaz, 2018;Eyigor et al, 2010;Gofeld et al, 2013;Korkmaz et al, 2010;Liliang et al, 2009;Okmen & Okmen, 2017;Sir & Eksert, 2019;Wu et al, 2014;Yan & Zhang, 2019), the Oxford Shoulder Score (OSS) (Jang et al, 2013;Kane et al, 2008;Keskinbora & Aydinli, 2009;Ozyuvaci et al, 2011;Taverner & Loughnan, 2014), the Constant-Murley Score (CMS) (Gofeld et al, 2013;Kane et al, 2008), the Nottingham Health Profile (NHP) (Okmen & Okmen, 2017), the Pain Self Efficacy Questionnaire (PSEQ) (Taverner & Loughnan, 2014), the Simple Shoulder Test (SST) (Yoshimura et al, 2018), range of movement (passive and active) (Bone et al, 2013;Ergonenc & Beyaz, 2018;Eyigor et al, 2010;Fernandes et al, 2011;Gurbet et al, 2005;Kim et al, 2012;Korkmaz et al, 2010;Lipov et al, 2013;Nakamura et al, 2013;Osako et al, 2016;Picelli et al, 2018;Pieran, 2010;Shah & Racz, 2003;Simopoulos et al, 2012;Sinha et al, 2020;Wu et al, 2014), the Disability Assessment Scale (DAS) (Picelli et al, 2018), the Fugl-Mey...…”

Efficacy and Safety of Ultrasound-Guided Radiofrequency Treatment for Chronic Pain in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

“…The sources of sensory nerve played the key role in knee pain and could help the operator to identify the appropriate branches of nerve for RF therapy with anatomic landmarks [ 36 – 38 ]. The studies by Ergonenc and Beyaz [ 39 ] and Wu et al [ 40 ]. have reported the effect of ultrasound-guided RF therapy on targeting suprascapular nerve for the treatment of chronic shoulder pain, indicating that ultrasound-guided RF therapy could also be applied to treat other diseases such as musculoskeletal pain.…”

Comparison of block and pulsed radiofrequency of the ganglion impar in coccygodynia

“…Anatomically, if we begin from the head region, we can first give examples of its use in occipital neuralgia and cervicogenic headaches [18]. Subsequent treatments include suprascapular, intercostal, dorsal root ganglia, and other peripheral nerves [19,20]. Apart from its use in nerves, there are also studies about the intraarticular and intralesional use of PRF [21,22].…”