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.
Often a group of nerves that cause pain to a specific organ or body region can be blocked with the injection of medication into a specific area of the body. The injection of this nerve-numbing substance is called a nerve block.
If the nerve pain is not responding to conservative treatment, such as anti-neuropathic medication, a nerve block is worth considering. This is not an invasive technique, but one where local anaesthetic and cortisone (a steroid) is injected into the muscle in the region where the dysfunctioning nerve passes through the muscles. The anaesthetic immediately dulls the pain, providing instant relief to the patient. The cortisone will then kick in at a very slow rate, soothing the nerves and inflammation.
All the aspects of the procedure are clearly explained to the patient, along with the possible risks and side effects. A consent form is signed to confirm approval. Where required, the patient’s medical history will also be discussed to ensure that no adverse factors are present.
After the patient has taken their position, patients are given an intravenous sedation to ensure the procedure is pain-free and easy to tolerate. Upon completion, the area to be injected is cleaned with a sterile scrub. Using x-ray guidance, the physician will then insert a needle through the skin and deeper tissues. The injection contains a mixture of local anaesthetic and cortisone (a steroid). The patient will then be monitored for a minimum of 30 minutes after the procedure is over and will then be allowed to return home.
After a week there is often a very significant reduction in pain, with up to 80% of patients feeling better.