Pulsed radiofrequency on suprascapular and axillary-circumflex nerve effective for Shoulder pain relief: Study

Recently published randomized clinical trial compared the efficacy of combined pulsed radiofrequency (PRF) on suprascapular nerve (SN) and axillary-circumflex nerve (ACN) versus PRF on SN alone for the treatment of painful shoulder. This comprehensive study provides valuable insights into the efficacy of PRF techniques for treating painful shoulders and highlights the safety and effectiveness of these procedures. Sixty patients were included in the trial, with the primary outcome being pain intensity measured by the Numerical Rating Scale (NRS), and secondary outcomes including the Shoulder Pain and Disability Index (SPADI), the Constant–Murley range of motion scale, and Disability of the Arm, Shoulder and Hand (DASH) scale. A decline in pain intensity was observed at the end of the study, with the combined PRF on SN and ACN not showing significant differences in NRS pain scores compared to single SN PRF. Similar results were observed in the secondary outcomes, with no significant differences in SPADI, Constant–Murley, and DASH scores between the study groups.

Study Conclusions and Limitations

The study concluded that combined PRF applied to SN and ACN was not superior to PRF applied to SN alone in reducing pain intensity and improving shoulder functionality. The technique was found to be safe and effective in treating painful shoulder, demonstrating reasonable pain relief without causing significant complications. The combined technique produced sustained pain relief, similar to the single puncture technique over SN, with no statistically significant benefits from the combined technique. Some limitations of the study were acknowledged, such as the absence of a group without intervention as a comparator and the broad inclusion criteria covering a wide range of pathologies in painful shoulder syndrome, making the extrapolation of results difficult.

Overall Study Conclusion

In conclusion, the study found that PRF over SN or over SN and ACN provides sustained pain relief in patients with painful shoulders, with the combined technique not offering statistically significant benefits over the single puncture technique over SN.

Key Points

- The study found that there were no significant differences in NRS pain scores or secondary outcomes between the two study groups. Combined PRF on SN and ACN was not superior to PRF on SN alone in reducing pain intensity and improving shoulder functionality. The technique was considered safe and effective, providing sustained pain relief without significant complications. However, the combined technique did not show statistically significant benefits over the single puncture technique over SN.

- The study concluded that PRF over SN or SN and ACN provides sustained pain relief in patients with painful shoulders. However, the combined technique did not offer statistically significant benefits over the single puncture technique over SN. The study acknowledged limitations such as the absence of a group without intervention as a comparator and the broad inclusion criteria, making the generalization of the results challenging.

Reference –

Miñana, José Miguel Esparza1,2,3; Mazzinari, Guido3,4; Llopis-Calatayud, Jose Emilio5,6; Cerdá-Olmedo, Germán7. Efficacy of pulsed radiofrequency on the suprascapular and axillary-circumflex nerve for shoulder pain: A randomised controlled trial. Indian Journal of Anaesthesia 68(5):p 473-479, May 2024. | DOI: 10.4103/ija.ija_1107_23