Pain Relief by Suprascapular Nerve Block in Gleno-humeral Arthritis

Brown, David E.; James, D.; Roy, Sasmit

doi:10.3109/03009748809105280

Cited by 73 publications

(43 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…8,9 Major disadvantages of targeting the SSN at the notch are the potential risk of pneumothorax, intravascular injection, injury, or misplacement. 10,11 The precision of the needle tip location can be improved by using imaging techniques, such as ultrasound, fluoroscopy, or computerized tomography (CT) scan guidance. However, CT scan is not widely available, and both CT scan and fluoroscopy imaging modalities expose the patient and healthcare professionals to radiation risk.…”

Section: Discussionmentioning

confidence: 99%

Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Peng

Wiley

Liang

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose Previous work on the ultrasound-guided injection technique and the sonoanatomy of the suprascapular region relevant to the suprascapular nerve (SSN) block suggested that the ultrasound scan showed the presence of the suprascapular notch and transverse ligament. The intended target of the ultrasound-guided injection was the notch. The objective of this case report and the subsequent cadaver dissection findings is to reassess the interpretation of the ultrasound images when locating structures for SSN block. Clinical features A 45-yr-old man with chronic shoulder pain received an ultrasound-guided SSN block using the suprascapular notch as the intended target. The position of the needle was verified by fluoroscopy, which showed the tip of the needle well outside the suprascapular notch. Similar ultrasound-guided SSN blocks were performed in two cadavers. Dissections were performed which showed that the needle tips were not at the suprascapular notch but, more accurately, were close to the SSN but at the floor of the suprascapular fossa between the suprascapular and spinoglenoid notch. Conclusion Our fluoroscopic and cadaver dissection findings both suggest that the ultrasound image of the SSN block shown by the well-described technique is actually targeting the nerve on the floor of the suprascapular spine between the suprascapular and spinoglenoid notches rather than the suprascapular notch itself. The structure previously identified as the transverse ligament is actually the fascia layer of the supraspinatus muscle.

show abstract

Section: Discussionmentioning

confidence: 99%

Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Peng

Wiley

Liang

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Some reports by Ritchie et al and Matsumoto et al also suggest it may supply 70 % of sensations to the skin of the shoulder (Brown, James et al 1988). …”

Section: Distributionmentioning

confidence: 99%

Arthroscopic Treatment of Suprascapular Nerve Neuropathy

Sahu¹,

Fullick²,

Lafosse³

2012

Applications of EMG in Clinical and Sports Medicine

View full text Add to dashboard Cite

“…Inflammation at night, with associated release of interleukin-1B and tumor necrosis factor-α may stimulate the local nerve endings through unknown mechanisms. Blocking the nerve supply to the shoulder certainly results in a decrease in the associated pain of glenohumeral arthritis [1]. Further, a recent study found that the same cytokines may stimulate expression of melatonon receptors 1A and 1B, and acid sensing ion channel 3 in the subacromial bursa and joint capsule [2].…”

mentioning

confidence: 99%

Sleeping on the Painful Shoulder: Always a Bad Night’s Sleep

Singh¹

2014

J Sleep Disord Ther

View full text Add to dashboard Cite

As orthopaedic surgeons, with a keen interest in shoulders, we commonly come across the patient who complains of pain with overhead activities and difficulty lifting heavy weights. A more common, and often subtler, complaint that points to shoulder pathology is pain sleeping on the affected shoulder at night. Many patients with shoulder pathology describe a deep aching pain to the shoulder at night made worse by the application of pressure while sleeping on the affected shoulder. The cause of this nocturnal sleep pain is unknown. It may be explained by biomechanical or biochemical causes.Sleeping on the affected shoulder rests the weight of the body (especially the upper torso) on the shoulder joint, which increases glenohumeral contact forces across the joint. To combat this, the human body has adaptive muscular mechanisms, primarily the rotator cuff stabilizers and the accessory shoulder muscles. In a study of 66 female subjects, Mork and Westgaard found that the deltoid was highly active during the sleep on painful shoulders, with the biceps, trapezius and hand flexors were not significantly different between the painful and pain-free shoulders. Further work is needed to study the musculature around the shoulder joint and its possible contribution to night pain.The nocturnal shoulder pain may also be related to biochemical causes. Inflammation at night, with associated release of interleukin-1B and tumor necrosis factor-α may stimulate the local nerve endings through unknown mechanisms. Blocking the nerve supply to the shoulder certainly results in a decrease in the associated pain of glenohumeral arthritis [1]. Further, a recent study found that the same cytokines may stimulate expression of melatonon receptors 1A and 1B, and acid sensing ion channel 3 in the subacromial bursa and joint capsule [2]. Luzindole, a melatonin-receptor antagonist, reversed melatonin stimulated ASIC3 expression and IL-6 production. Clearly this is an exciting field that needs further work.Interestingly, a recent study of 83 patients with unilateral shoulder pain found that patients preferred to sleep on their painful side [3]. This may suggest that the shortening of the capsule stretch by pressure may actually reduce pain.We as orthopaedic surgeons have long been aware of this symptom and is one of the first questions we ask to a patient that presents to our clinic with a painful shoulder. Our confidence in this screening question is reflected in it being employed in a variety of tools designed for clinical and academic purposes [4][5][6].In an attempt for symptomatic management of these patients, we commonly prescribed analgesics and anti-inflammatory medications that do not act centrally. The results are satisfactory, with the patients often stating that they are able to elevate their shoulders and have improved sleep. However, in our practice, sleep does not return to baseline for weeks to months after improvement in pain and function. Patients state that sleep is fine, but on further probing often rescind this statement.What i...

show abstract

Pain Relief by Suprascapular Nerve Block in Gleno-humeral Arthritis

Cited by 73 publications

References 1 publication

Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Arthroscopic Treatment of Suprascapular Nerve Neuropathy

Sleeping on the Painful Shoulder: Always a Bad Night’s Sleep

Contact Info

Product

Resources

About