Efficacy of pulsed mode radiofrequency lesioning of the suprascapular nerve in chronic shoulder pain secondary to rotator cuff rupture

Abstract

Suprascapular nerve blockade can he performed in chronic shoulder pain secondary to rotator cuff lesions, shoulder joint osteoarthritis, and adhesive capsulitis. Local anesthetics and steroids are commonly combined for the blockade. In this report, we present pulsed mode radiofrequency lesioning of suprascapular nerve for persistent shoulder pain in 8 patients. 8 patients with no response to six weeks physical or medical treatment were hospitalized in our Algology Clinic for suprascapular nerve pulsed mode radiofrequency lesioning. All blocks were performed in sitting position with a 22-Gauge, 100 mm "SMK" needle with 5 mm active tip and "Radionics" radiofrequency generator. Sensory stimulation at 50 Hz, 0.2 millisecond pulse width was performed and paresthesias in the shoulder joint occurred at 0.3 V. Motor stimulation at 2 Hz, 0.2 millisecond pulse width showed the contractions of the infraspinatus and supraspinatus muscles occurred at 0.4-0.5 V. Pulsed mode radiofrequency lesioning was then carried out two times for 120 seconds at 2 Hz frequency and pulse width of 20 milliseconds at 42 °C. Patients were evaluated for pain scores and shoulder joint movements at 1, 2, 4, 8, and 12 weeks after the procedure. Pulsed mode radiofrequency lesioning of suprascapular nerve block provided pain control for at least twelve weeks and improved shoulder joint movements.