Shoulder pain refers to any form of pain felt in the shoulder or around the shoulder joint. The shoulder joint is the most mobile joint in the human body, including four tendons that have the function of holding the muscle to the bone. Any swelling, inflammation, tearing or bony changes around the tendons in the shoulder causes pain when a person tries to move the arm upwards, backwards, straight out or in front.
Common causes include bursitis, rotator cuff tendonitis and tears or ruptures to any of the four tendons. Shoulder instability and dislocation is very common, leading to a host of conditions in this complex area of the body.
The suprascapular nerve runs along the back of the shoulder. It can get stretched or compressed enough to cause serious damage. This condition is called suprascapular neuropathy and it often results in nerve pain and loss of function in the shoulder.
Pulsed Radiofrequency Treatment
Pulsed radiofrequency treatment is a minimally invasive procedure in which the nerves that are causing pain are blasted with short bursts of radiofrequency waves. Unlike the traditional radiofrequency technique, which denervates the nerve with extreme heat to cause a permanent loss of sensation in the nerve, pulsed radiofrequency leaves no lasting damage. The nerves feel fine afterwards and are simply ‘retuned’ so that they no longer feel pain. For this reason, if it is deemed an appropriate treatment for the particular pain, pulsed radiofrequency is a preferred method of radiofrequency, allowing patients to undergo a very low risk procedure. It is effective, drug free and lasts for a couple of months.
Pulsed radiofrequency treatment is performed as an outpatient procedure at the London Pain Clinic, with patients free to leave as soon as the treatment has been administered. The area of nerve pain is located and is then sterilised with a chlorhexidine antiseptic spray. A fast acting local anaesthetic will be injected through a small cosmetic needle.
During the procedure, a catheter is fitted in the immediate vicinity of the affected nerve. The pulsed radiofrequency will then direct an electromagnetic field into the catheter, tricking the nerve into thinking that it is not experiencing pain, so that it no longer sends signals to the brain telling it so.
Some patients can experience pain with this procedure and some relate that their condition may be slightly more painful for a few days after treatment, but the nerve will then return to its natural state and the pain will effectively disappear.
The procedure will take around an hour. The patient may be anaesthetised or sedated to ensure that the catheter can be inserted and that there is minimal movement while the procedure is being carried out.
Many patients respond well to only one session of pulsed radiofrequency, so it could well be that only one session is required to alleviate the pain. However, patients react differently according to their own particular condition, what caused the shoulder pain in the first place and whether or not they have any other underlying medical conditions. However, most people will only require one or two sessions to experience significant improvement.