Suprascapular Nerve Blocks... the future?
In the past decade numerous studies have been published evaluating the efficacy of suprascapular nerve (SSN) blocks on patients with adhesive capsulitis and other chronic shoulder pain syndromes.
The SSN is a branch off of the C5 & C6 and enters the suprascapular fossa via the suprascapular notch. The suprascapular nerve innervates the supraspinatus and infraspinatus and supplies up to 70% of the shoulder sensory region.
The injection of 5ml ropivacaine 0.5% has been shown to significantly reduce pain in patients with chronic shoulder pain who had not responded to physiotherapy treatments. The patient population has included those diagnosed with adhesive capsulitis, rotator cuff impingements, tears and/or calcifications.
Interestingly similar positive outcomes have been found when injections are done “blindly” in a clinic using anatomical landmarks and when done using guided imaging in a hospital setting. Therefore, this relatively simple and safe injection procedure can be given by an MD in an outpatient setting without the need for imaging tools.
I have yet to have a patient who has received a SSN block, but perhaps with growing evidence, some MDs may consider it over traditional cortisone injections. If you have experience with SSN blocks, please contact me …I would really love to know how if it works!
References: Dorn C et al The Effect of the Modified Lateral Suprascapular Block on Shoulder Function in Patients With Chronic Shoulder Pain. Anesth Pain Med. 2015 Dec 5;5(6):e31640.
Matsumoto D et al A new nerve block procedure for the suprascapular nerve based on a cadaveric study. J Shoulder Elbow Surg. 2009 Jul-Aug;18(4):607-11.
Shanahan EM et al Suprascapular nerve block in chronic shoulder pain: are the radiologists better? Ann Rheum Dis. 2004 Sep;63(9):1035-40.