329: Pulsed Rf of supra scapular,Axillary and Lateral Pectoral nerve for shoulder pain-outcome

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Non-pharmacological treatments, Neuromodulation (e.g. TMS, TDCS, FUS, SCS, MCS, DBS, vagus nerve stimulation), Treatment/management

Background and Aims: Shoulder pain is 3rd most common musculoskeletal pain. The prevalence of Frozen shoulder (Adhesive Capsulitis) is 2 - 5%. Fibroproliferative tissue fibrosis and inflammatory contracture of the rotator interval, capsule, and ligaments leading to significant restriction of range of motion (typically external rotation).Here we are presenting case series of 20 cases of pulsed radiofrequency neuromodulation of 3 nerves of shoulder joint, Suprascapular, Axillary and Lateral pectoral nerves for treatment of Adhesive capsulitis.

Methods: MATERIAL AND METHODSThe-
Under ultrasound guidance, Pulsed RF neuromodulation was done for Suprascapular nerve, Lateral pectoral nerve and Axillary nerve followed by Hydro distension of glenohumeral joint under ultrasound guidance. After procedure shoulder joint manipulation was done and patients discharged on same day after 2 hour observation. Patients were followed up for 6 months post operatively.
Assessment of Pain and functional activity was done using comparison of pre- and post-operative NRS and SPADI Primary outcome- Pain and functional activity of shoulder joint, active and passive Range of motion (ROM).Secondary outcome – Any adverse effects (eg infection, bleeding , paralysis )

Results: There was significant improvement in NRS and SPADI scores and ROM post-operatively. There was good response to treatment (60.68±13.75 in NRS; 57.49±12.55 SPADI) at the end of 6 months post operatively.

Conclusions: CONCLUSION

Pulsed radiofrequency neuromodulation of three nerves of shoulder i.e Suprascapular , Lateral pectoral and Axillary along with Hydrodistension is a promising technique for combating the pain and movement restriction due to Adhesive capsulitis having fewer adverse effects
ADVERSE None of 20 patients reported any adverse effects.

References: REFERENCES

1. Challoumas D, Biddle M, McLean M, Millar NL. Comparison of Treatments for Frozen Shoulder: A Systematic Review and Meta-analysis. JAMA Netw Open 2020 Dec 1;3(12):202. Cho CH, Bae KC, Kim DH. Treatment Strategy for Frozen Shoulder. Clin Orthop Surg. 2019 Sep;11(3):249-257. 3. Pandey, V., Madi, S. Clinical Guidelines in the Management of Frozen Shoulder: An Update. JOIO 2021;55:299–309

Presenting Author: Dr Krishna Poddar
Submitting Author: Krishna Poddar

Senior Author: dDr Krishna Poddar

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• KRISHNA PODDAR: MBBS,MD,FIAPM - CENTRAL HOSPITAL ,SER KOLKATA