Pulsed Radiofrequency of Suprascapular Nerve and Shoulder Joint for Chronic Shoulder Pain
Status:
Recruiting
Trial end date:
2022-12-01
Target enrollment:
Participant gender:
Summary
Background: The suprascapular nerve block is frequently used to treat chronic shoulder pain.
The nerve blockade provides probably only a short-term relief, and more compelling approaches
have been investigated. Pulsed radiofrequency stimulation of suprascapular nerve has been
reported as safe and reliable method for pain treatment. However, formal efficacy study for
pRF stimulation of the shoulder joint has not been published. Evidence-based validation of a
new method is necessary for both scholastic and practical purposes.
Methods: This study is a randomized active controlled blind trial. Lidocaine injections alone
and pRF stimulation with two different combinations will be performed. Participants will be
followed during 6 months, and subjective and objective outcome variables will be recorded.
Patients are randomly allocated for suprascapular nerve block (n=50), for suprascapular nerve
pRF stimulation (n=50) or for both suprascapular nerve blocks and humeroscapular joint pRF
stimulation (n=50). All patients will receive standardized physical therapy at the unit of
physical medicine and rehabilitation.
Results: Pulsed radiofrequency is thought to be a non-neurolytic neuromodulation method with
some effectiveness in relieving of both experimental and clinical neuropathic pain. Our
earlier results suggest additional therapeutic benefit obtained when pRF was performed in
addition to physiotherapy (TAU). In a review, Chan et al. (2016) concluded that SSNB
treatment could be more effective in treating pain in patients with longstanding rheumatoid
arthritis when compared to intra-articular injection of corticosteroid. Also short-term pain
reduction occurred in patients with chronic rotator cuff lesions. With regard to adhesive
capsulitis, SSNB treatment showed a greater effect in relieving pain but on functional
outcome, the results were inconclusive.
Discussion: In summary, this study investigate effects of pRF for patients with chronic
shoulder pain from arthritis, frozen shoulder and/or degenerative shoulder disease. PRF can
be performed in an outpatient department and provides the clinician with an alternative or
additional approach to oral drug treatment and intra-articular injection. Further, it may
prove to be a useful treatment for patients who are unfit or unwilling to consider surgical
intervention.