Suprascapular Nerve Ablation – Pulsed Radiofrequency Denervation or Neurotomy

What is Suprascapular Nerve Ablation?

Suprascapular nerve ablation, also known as suprascapular nerve pulsed radiofrequency denervation, is a minimally invasive procedure aimed at providing relief from chronic shoulder and neck pain. 

The procedure involves using a specialised needle that is guided into place using fluoroscopy, CT or ultrasound imaging. Once in position, radiofrequency energy is applied to the nerves to heat and disable them, thereby interrupting the transmission of pain signals. Pulsed radiofrequency denervation does not ‘burn and destroy’ the nerve, it is designed to ‘modulate’ the nerve such that the pain signals are interrupted. 

This procedure can provide significant and long-lasting pain relief for individuals suffering from shoulder pain stemming from trauma, inflammation, cancer-related pain, or similar conditions. Suprascapular nerve ablation is considered to be an effective non-surgical treatment option for managing chronic shoulder pain when more conservative measures have failed.

How Does Suprascapular Nerve Pulsed Radiofrequency Denervation Alleviate Chronic Shoulder Pain?

Suprascapular nerve pulsed radiofrequency denervation alleviates pain in the shoulder area by disrupting the transmission of pain signals from the nerves to the brain.  

During a suprascapular nerve ablation, a specialised needle is precisely guided to the suprascapular nerve surrounding the shoulder joint. After the needle is in position, radiofrequency energy is applied to these nerves, generating heat and effectively disabling them. By targeting and deactivating these nerves, the communication of pain signals from the shoulder to the brain is interrupted and the sensation of discomfort is diminished or eliminated.

As a result, patients who undergo suprascapular nerve ablation experience relief from chronic shoulder pain. This pain relief can be significant and long-lasting, providing patients with improved mobility, function, and overall quality of life.

Suprascapular nerve ablation is considered a minimally invasive and safe procedure, offering an alternative to more invasive treatments like surgery. It can be particularly beneficial for individuals who have not responded well to more conservative therapies or who wish to avoid surgical intervention.

Why Would You Get Suprascapular Nerve Ablation for Chronic Pain?

Pain management specialists often recommendation suprascapular nerve ablation or pulsed radiofrequency denervation for chronic shoulder pain if:

• More conservative treatments haven’t worked for you. If your pain hasn’t responded to medications, physical therapy, injections, and other less invasive treatments for shoulder pain, then suprascapular nerve ablation could be an option.
• You do not want to get surgery. Suprascapular nerve ablation is a conservative procedure that can provide pain relief without surgical intervention. If you prefer to avoid surgery or if you’re not a candidate for surgery due to health reasons, suprascapular nerve ablation may be a solution.
• You cannot have surgery. If you have a medical condition or other factors that make you an unsuitable candidate for surgery, suprascapular nerve ablation may be a good nonsurgical option for managing your shoulder pain effectively.
• You’ve had unsuccessful shoulder surgery or surgeries. If you’ve undergone surgery on your shoulder and your pain persists, suprascapular nerve ablation may be a good option to alleviate chronic pain.
• You need more long-term reduction in pain. Suprascapular nerve ablation can provide long-lasting pain relief for patients with chronic shoulder pain. By targeting the nerves responsible for transmitting pain signals from the shoulder, this procedure can offer relief that extends beyond the duration of temporary treatments like suprascapular nerve block injections.
• You want to improve your everyday life. Long-term shoulder pain can significantly impact your routine and ability to make future plans. By effectively managing pain through suprascapular nerve ablation, your overall quality of life may be enhanced.

You can discuss your specific situation with a pain specialist at Persistent Pain Solutions to determine if suprascapular nerve ablation is a suitable treatment option for you. Dr Meena Mittal and her team will assess your medical history, perform a complete assessment and provide personalised recommendations based on your health concerns. 

Risks of Suprascapular Nerve Pulsed Radiofrequency Denervation/ Ablation

Suprascapular nerve ablation is generally considered safe,but  like any medical procedure, it carries some potential risks and complications. These may include:

• Injection Site Reactions. Some patients may experience temporary pain, discomfort, or bruising at the injection site.
• Flare up of pain. There may be a temporary flare up of pain which is usually a ‘pressure effect’ from the injection.
• Infection.  Any invasive procedure carries a risk of infection. Though rare, infection can occur at the injection site or in the surrounding tissues, leading to complications that may require further treatment. Signs of infection include increased pain, swelling, redness, or drainage from the injection site. Proper sterile techniques are employed to minimise this risk.
• Bleeding. There is a risk of bleeding at the injection site, especially for patients taking blood-thinning medications. This can lead to hematoma (collection of blood) at the injection site.
• Allergic Reactions. Allergic reactions to the medications used in the injection, such as local anaesthetics or corticosteroids, are possible but uncommon. If a contrast dye is used during the procedure, there’s a slight risk of an allergic reaction to the dye, which may include rash, itching, or more severe reactions like anaphylaxis.
• Short term numbness and weakness. It is normal to experience this in the arm and it generally lasts for 4-6 hours after the procedure. It resolves as the local anaesthesia wears off. 
• Nerve Damage. Although rare, there’s a risk of nerve damage due to needle placement (direct trauma), the medication injected, infection or bleeding. Symptoms may include numbness, tingling, weakness, or increased pain. Some patients may experience temporary nerve irritation or exacerbation of pain following the injection, which usually resolves on its own.
• Steroid related side effects. Corticosteroids used in the injection can temporarily increase blood sugar levels in patients with diabetes. There may be transient flushing, mood swings and insomnia on the day of the procedure. 
• Exposure to X-Rays and CT. Minimal doses of radiation are used to reduce the lifetime risk of long term complications (such as cancer) due to exposure to X-ray and/ or CT scanning.
• Failure. The procedure may not provide the expected result or benefit.

It is essential to discuss the potential risks and benefits of getting a suprascapular nerve ablation with your doctor before undergoing the procedure. 

Dr Mittal and her team at Persistent Pain Solutions can provide personalised recommendations based on your medical history, specific condition, and individual risk factors. 

Additionally, following post-procedure instructions and attending follow-up appointments can help to mitigate any potential complications.

The Process of Getting Suprascapular Nerve Ablation

The process of getting suprascapular nerve ablation typically involves a series of steps, including an initial evaluation, preparation, the procedure itself, and post-procedure care. 

Here’s an overview:

1. Evaluation. Your doctor will conduct a thorough evaluation to determine if suprascapular nerve ablation is an appropriate treatment for your chronic neck and shoulder pain. This may include a review of your medical history, physical examination, imaging studies (such as X-rays or MRI), and possibly diagnostic nerve blocks to confirm the source of your pain.
2. Pre-Procedure Prep. Once suprascapular nerve ablation is deemed suitable for your chronic pain issues, your doctor will provide instructions on how to prepare for the procedure. This may include fasting for a certain period before the procedure, temporarily discontinuing certain medications (such as blood thinners), and arranging for transportation to and from the medical facility.
3. Day of the Procedure. On the day of your shoulder nerve ablation, you will typically check in at the medical facility, where you may be asked to change into a hospital gown. You’ll then be taken to a procedure room, where the procedure will take place.
4. Procedure. Suprascapular nerve ablation is performed using fluoroscopy (a type of X-ray) or CT or ultrasound guidance to ensure precise placement of the needle. You will receive a local anaesthetic to numb the skin and underlying tissues at the insertion site. Once numb, a needle will be inserted next to the targeted nerves. Radiofrequency energy is then delivered through the needle to deactivate the nerves, interrupting the transmission of pain signals. The procedure typically takes about 30 minutes to complete.
5. Post-Procedure Care. After your shoulder nerve ablation, you will be monitored for a short period in a recovery area to ensure there are no immediate complications. You may experience some discomfort or mild soreness at the procedure site, which can usually be managed with over-the-counter pain medications. Your doctor will provide specific instructions on post-procedure care, including any restrictions on activities and when you can resume normal daily activities.
6. Follow-up Care. Post-ablation appointments may be scheduled to monitor your progress and assess the effectiveness of the procedure. You may require additional treatments or adjustments to your pain management plan based on your response. 

Throughout the entire suprascapular nerve ablation process, it’s important to communicate openly with your doctor, ask any questions you may have, and follow their instructions carefully to ensure the best possible outcome.

Preparing for Suprascapular Nerve Ablation

Preparing for a suprascapular pulsed radiofrequency denervation at the Persistent Pain Solutions clinic will require close communication with Dr Mittal and her team. 

Be sure to disclose all medications you may be taking and note that you may have to discontinue some or all of them immediately prior to the procedure.

Prior to your appointment, please inform us if:

• You are currently taking antibiotics.
• You have a pacemaker or defibrillator.
• You have any allergies.
• You have diabetes.
• You are taking any blood thinning medications.
• You are feeling unwell, as we may need to reschedule your procedure.

For your safety, we recommend arranging transportation to and from your appointment, as driving yourself is not advised within the 24-hour period following the procedure.

We generally recommend you take leave from work on the day of the procedure AND one day after the procedure, to rest and recover from the procedure. 

If you are receiving suprascapular nerve ablation, we advise you to refrain from undergoing any additional medical procedures, such as dental treatments or colonoscopies, within 48 hours before or after receiving the pain intervention. 

Dr Meena Mittal and her team will provide specific guidance tailored to your situation. It’s important to adhere to your instructions diligently. If you have any concerns or queries, don’t hesitate to ask—we’re here to support you throughout the process.

After Getting Suprascapular Nerve Pain Ablation (Follow-Up)

Following your suprascapular nerve ablation procedure, you are free to return home. 

There are no specific restrictions on your day-to-day activities. However, it’s advisable to prioritise rest and engage in gentle activities during the initial 24 hours after your procedure.

Occasionally, you may experience some discomfort or bruising at the injection sites. Occasionally there is a temporary flare up of the pain.

You may commence physiotherapy one week after the procedure. You may return to hydrotherapy or a swimming pool/ spa two weeks after the procedure. 

We do not recommend any long distance or overseas travel for at least two weeks after the procedure. This is such that any issues or complications can be monitored and addressed in a timely manner. 

A follow-up appointment will be scheduled at 6 weeks post procedure to assess your response to the procedure. You will be requested to bring the post procedure Pain Chart such that the results can be analysed by Dr Mittal and next steps in your treatment plan can be discussed with you. 

How Long Does a Suprascapular Nerve Ablation Last?

The pain relief from getting a suprascapular nerve ablation varies based on your individual situation and depends on your particular condition, the intensity of your pain, and your response to the injection. In general, the effects of this procedure can last anywhere from several weeks to several months or even years. On average, it lasts for anywhere between 12-18 months but once again, this varies depending on the individual patient.

It’s important to note that while a suprascapular nerve ablation can often alleviate your shoulder pain in the short term, these types of procedures are often part of a comprehensive treatment plan that may include physical therapy, medications, and other interventions. 

Ultimately, the length of time that the pain relief from a suprascapular nerve ablation will occur, should be discussed with your pain management doctor. Dr Mittal and her team can provide personalised guidance based on your specific circumstances, health concerns, and pain levels.  

Finding a Doctor Who Performs Suprascapular Nerve Ablation Near You

If you are suffering from chronic shoulder pain and wish to avoid surgical interventions, then a pain specialist who can perform a suprascapular nerve ablation may be able to provide some pain relief. Chances are, your pain management doctor will start with a suprascapular nerve block and move on from there to an ablation or denervation if the nerve block works well for you. 

Request a referral to a specialist in shoulder pain from your general practitioner and consider suggestions from family members, friends, or support groups (both online and in real life) who have dealt with similar chronic pain problems.

Suprascapular Nerve Ablation at Persistent Pain Solutions

Dr Mittal and her team at the Persistent Pain Solutions clinic provide suprascapular nerve ablations and suprascapular nerve blocks, procedures designed to alleviate shoulder pain, referred neck pain, and referred chronic headaches. 

This technique works by targeting the suprascapular nerves surrounding the shoulder. Suprascapular nerve ablations provide temporary relief, they typically follow a successful suprascapular nerve block, which serves as a way of locating and diagnosing the exact source of your pain.

If the nerve block alleviates your shoulder pain, then Dr Mittal and her team follow up with a nerve ablation, a technique where a small portion of nerve tissue is incapacitated. This effectively interrupts pain signals, providing long-term relief from chronic shoulder pain.

As always, we prioritise personalised care and strive to provide effective solutions for managing chronic shoulder pain and improving our patients’ quality of life.