Effect of Pulsed Radiofrequency Neuromodulation on Clinical Improvements in the Patients of Chronic Intractable Shoulder Pain

Objective : The aim of this study was to evaluate effect of pulsed radiofrequency (PRF) neuromodulation of suprascpaular nerve (SSN) in patients with chronic shoulder pain due to adhesive capsulitis and/or rotator cuff tear. Methods : The study included 11 patients suffering from chronic shoulder pain for at least 6 months who were diagnosed with adhesive capsulitis (n=4), rotator cuff tear (n=5), or adhesive capsulitis+rotator cuff tear (n=2) using shoulder magnetic resonance imaging or extremity ultrasonography. After a favorable response to a diagnostic suprascapular nerve block twice a week (pain improvement >50%), PRF neuromodulation was performed. Shoulder pain and quality of life were assessed using a Visual Analogue Scale (VAS) and the Oxford Shoulder Score (OSS) before the diagnostic block and every month after PRF neuromodulation over a 9-month period. Results : The mean VAS score of 11 patients before PRF was $6.4{\pm}1.49$, and the scores at 6-month and 9 month follow-up were $1.0{\pm}0.73$ and $1.5{\pm}1.23$, respectively. A significant pain reduction (p<0.001) was observed. The mean OSS score of 11 patients before PRF was $22.7{\pm}8.1$, and the scores at 6-month and 9 month follow-up were $41.5{\pm}6.65$ and $41.0{\pm}6.67$, respectively. A significant OSS improvement (p<0.001) was observed. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective treatment for chronic shoulder pain, and the effect was sustained over a relatively long period in patients with medically intractable shoulder pain.