Suprascapular Nerve Block Injections Melbourne

What Are Suprascapular Nerve Block Injections?

A suprascapular nerve block is a medical procedure performed to alleviate pain in the shoulder region. The suprascapular nerve is a major nerve that innervates the shoulder joint and surrounding tissues. When this nerve becomes irritated or compressed or activated due to conditions such as rotator cuff injuries, arthritis, or other shoulder disorders, it can lead to significant pain and discomfort.

During a suprascapular nerve block, a local anaesthetic, sometimes combined with a corticosteroid, is injected near the suprascapular nerve to numb the area and reduce inflammation. This procedure can provide temporary relief from pain and improve mobility in the shoulder joint.

Suprascapular nerve blocks are often used as part of a comprehensive treatment plan for shoulder pain and dysfunction. They may be recommended when conservative treatments such as rest, physical therapy, and medications have not provided sufficient relief. 

Additionally, suprascapular nerve blocks can be used both for diagnostic purposes, to confirm that the suprascapular nerve is the source of pain, and for therapeutic purposes, to manage the pain directly.

It is essential to note that while suprascapular nerve blocks can be effective in providing short-term pain relief, they are not typically a permanent solution and may need to be repeated periodically for ongoing management of shoulder pain. 

As with any medical procedure, there are potential risks and complications associated with suprascapular nerve blocks, so it is crucial to discuss the procedure thoroughly with a healthcare provider and weigh the potential benefits against the risks.

What Conditions Do Suprascapular Nerve Block Injections Treat?

Suprascapular nerve blocks are primarily used to alleviate pain and discomfort associated with conditions affecting the shoulder region. These conditions may include:

• Rotator Cuff Injuries. Tears or strains in the tendons of the rotator cuff muscles can cause significant pain and limited shoulder mobility.
• Shoulder Arthritis. Arthritis, whether osteoarthritis or inflammatory arthritis such as rheumatoid arthritis, can lead to joint inflammation, pain, and stiffness in the shoulder.
• Frozen Shoulder (Adhesive Capsulitis). This condition involves the gradual loss of shoulder mobility accompanied by pain and stiffness.
• Shoulder Impingement Syndrome. This is characterised by the compression of tendons or bursa in the shoulder joint, resulting in pain and limited range of motion.
• Shoulder Bursitis. Inflammation of the bursae, small fluid-filled sacs that cushion the shoulder joint, leading to pain and swelling.
• Chronic Shoulder Pain. Persistent pain in the shoulder area that may be due to various underlying conditions or injuries.
• Post Surgical Pain. This is ongoing pain after undergoing shoulder surgery, usually neuropathic in nature.

Suprascapular nerve blocks can be an effective component of a comprehensive treatment plan for these conditions, providing temporary relief from pain and facilitating physical therapy or rehabilitation efforts. However, they are not typically considered a permanent solution and may need to be repeated periodically for ongoing pain management.

How Do Suprascapular Nerve Block Injections Alleviate Chronic Pain?

Suprascapular nerve injections alleviate chronic shoulder pain by targeting the suprascapular nerve, which is a major nerve responsible for transmitting pain signals from the shoulder joint to the brain. These injections typically involve the administration of a local anaesthetic, such as lignocaine or bupivacaine, along with a corticosteroid medication.

• Local Anaesthetic. The local anaesthetic works by temporarily blocking the transmission of pain signals along the suprascapular nerve fibres. By numbing the nerve, it interrupts the communication of pain sensations from the shoulder to the brain, providing immediate relief.
• Corticosteroid Medication. The corticosteroid medication included in the injection has both anti-inflammatory and pain-relieving properties. It helps reduce inflammation and swelling in the shoulder joint, which are often contributing factors to chronic shoulder pain. Additionally, corticosteroids can help suppress the activity of inflammatory cells and mediators, further alleviating pain and promoting healing.

Together, the combination of local anaesthetic and corticosteroid in the suprascapular nerve injection provides both immediate and longer-lasting relief from chronic shoulder pain. The local anaesthetic offers immediate numbing effects, providing immediate pain relief, while the corticosteroid works to reduce inflammation and alleviate pain over the following days to weeks.

It’s important to note that while suprascapular nerve injections can be effective in managing chronic shoulder pain, they are typically part of a comprehensive treatment plan that may also include physical therapy, medications, and other interventions. 

Be aware that the duration of pain relief from these injections can vary from person to person, and repeat injections may be necessary for long-term management of chronic shoulder pain. Depending on the situation, patients may be offered to proceed with Pulsed radiofrequency denervation of the suprascapular nerve to provide longer term pain relief.

Why Would You Get Suprascapular Nerve Block Injections for Chronic Pain?

Suprascapular nerve block injections may be recommended for chronic shoulder pain when conservative treatments such as rest, physical therapy, and oral medications have not provided sufficient relief. Here are several reasons why someone might consider suprascapular nerve block injections for chronic pain:

• Targeted Pain Relief. Suprascapular nerve block injections deliver medication directly to the suprascapular nerve, which is responsible for transmitting pain signals from the shoulder joint to the brain. By targeting this specific nerve, the injections can provide localised pain relief.
• Diagnostic Tool. In some cases, suprascapular nerve block injections can serve as a diagnostic tool to help identify the source of shoulder pain. If the injection provides significant pain relief, it suggests that the suprascapular nerve is contributing to the pain, confirming the diagnosis.
• Reduced Inflammation. The corticosteroid medication included in the injection has potent anti-inflammatory properties. By reducing inflammation in the shoulder joint, the injections can alleviate pain and improve mobility.
• Minimally Invasive. Suprascapular nerve block injections are minimally invasive procedures that can be performed on an outpatient basis. They typically involve less risk and shorter recovery times compared to surgical interventions.
• Avoidance of Systemic Side Effects. Since the medication is delivered directly to the affected area, suprascapular nerve block injections may result in fewer systemic side effects compared to oral medications, which can affect the entire body.
• Improved Function. By alleviating pain and inflammation, suprascapular nerve block injections can help improve shoulder function and mobility, allowing individuals to participate more fully in daily activities and rehabilitation exercises.

Overall, suprascapular nerve block injections can be a valuable option for patients who are experiencing chronic shoulder pain that has not responded adequately to other treatments. 

However, it’s important to discuss the potential benefits and risks of this procedure with a pain specialist or similar healthcare provider to determine if it’s the right course of action for your specific situation.

Risks of Suprascapular Nerve Block Injections

The suprascapular nerve block procedure is generally low-risk, it is important to acknowledge potential complications associated with any medical intervention. 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.
• 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. 
• 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. 
• 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. 
• 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.

The Process of Getting Suprascapular Nerve Block Injections

The process of receiving suprascapular nerve injections typically involves several steps, from preparation to post-procedure care. Here’s a detailed overview of the process:

1. Initial Consultation. The process usually begins with an initial consultation with a healthcare provider specialising in pain management, such as a pain management physician or an interventional radiologist. During this consultation, the healthcare provider will review your medical history, perform a physical examination, and discuss your symptoms and treatment goals.
2. Discussion of Procedure. Your pain specialist will explain the suprascapular nerve block procedure in detail, including its purpose, potential benefits, risks, and alternatives. They will address any questions or concerns you may have and ensure you understand what to expect.
3. Pre-procedure Instructions. You may receive specific instructions to prepare for the procedure, such as discontinuing certain medications or fasting for a specified period before the appointment. It’s essential to follow these instructions carefully to ensure the success and safety of the procedure.
4. Procedure Day. On the day of the procedure, you’ll arrive at the clinic or outpatient facility where the injection will be performed. You may be asked to change into a gown and sign consent forms indicating your understanding of the procedure and its risks.
5. Positioning. You’ll be positioned comfortably on an examination table, typically lying on your back or side, depending on the healthcare provider’s preference and the equipment used.
6. Sterilisation. The injection site will be cleaned and sterilised to reduce the risk of infection. The healthcare provider may use an antiseptic solution, such as iodine or alcohol, to cleanse the area thoroughly.
7. Local Anaesthesia, Before administering the suprascapular nerve block injection, the healthcare provider will numb the skin and deeper tissues around the injection site using a local anaesthetic. This helps minimise discomfort during the procedure.
8. Injection Placement. Using imaging guidance, such as ultrasound or fluoroscopy (real-time X-ray) or CT,  the healthcare provider will accurately locate the suprascapular nerve and position the needle for the injection. The injection may contain a combination of local anaesthetic and corticosteroid medication.
9. Injection Administration. Once the needle is correctly positioned, the medication is injected slowly and precisely into the target area around the suprascapular nerve.
10. Post-procedure Monitoring. After the injection, you may be monitored for a short period to ensure there are no immediate complications or adverse reactions. Vital signs such as blood pressure, heart rate, and oxygen saturation may be monitored.
11. Post-procedure Instructions. You’ll receive instructions on post-procedure care, including any activity restrictions, medication usage, and signs of potential complications to watch for. It’s essential to follow these instructions closely to optimise the outcome of the injection.
12. Follow-up Appointment. Depending on the healthcare provider’s recommendations, you may schedule a follow-up appointment to assess your response to the injection and determine the need for additional treatments or interventions.

Overall, the process of receiving suprascapular nerve injections is generally well-tolerated and can provide significant relief for individuals experiencing chronic shoulder pain. However, it’s crucial to discuss any questions or concerns with your pain management doctor and their team and adhere to the appropriate guidance throughout the entire treatment process.

Preparing for Suprascapular Nerve Block Injections

Preparing for a suprascapular nerve block 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 blocks, we advise you to refrain from undergoing any additional medical procedures, such as dental treatments or colonoscopies, within 48 hours before or after receiving a suprascapular nerve block. 

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 Block Injections (Follow-Up)

Following your suprascapular nerve block 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 2 weeks post procedure to assess your response to the suprascapular nerve block. 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 Block Injection Last?

The duration of pain relief provided by a suprascapular nerve block injection can vary from person to person and depends on several factors, including the individual’s condition, the severity of their pain, and their response to the injection. Typically, the effects of a suprascapular nerve block can last anywhere from several weeks to several months.

In some cases, patients may experience immediate relief that lasts for several days, followed by a gradual return of symptoms as the effects of the local anaesthetic wear off. The full benefit of the injection, often provided by the steroid medication, may take a few days to a week to become apparent. This effect can last for weeks to months, providing extended pain relief and improved function in the shoulder joint.

It’s important to note that while a suprascapular nerve block can provide significant pain relief, it is often part of a comprehensive treatment plan that may include physical therapy, medications, and other interventions. Repeat injections or proceeding with a pulsed radiofrequency denervation of the suprascapular nerve may be necessary for long-term management of chronic shoulder pain, depending on the underlying condition and your individual response to treatment.

Ultimately, the duration of pain relief from a suprascapular nerve block injection should be discussed with your pain management doctor, who can provide personalised guidance based on your specific circumstances.

Finding a Doctor Who Performs Suprascapular Nerve Block Injections Near You

If you are suffering from chronic shoulder pain due to frozen shoulder, shoulder bursitis, shoulder impingement syndrome, rotator cuff injuries, shoulder arthritis, or another form of chronic shoulder pain, then a pain specialist in Melbourne who can perform a suprascapular nerve block may be able to provide some short term relief.

Ask your general practitioner for a referral to a pain management physician who offers suprascapular nerve blocks or injections or similar procedures for shoulder pain. You can also research pain management clinics online or speak to family members, friends, or support groups (both online and in real life) for recommendations from those who have dealt with similar painful shoulder issues or other chronic pain problems. 

Suprascapular Nerve Blocks at Persistent Pain Solutions

Persistent Pain Solutions provides suprascapular nerve block injections. This technique is a procedure designed to alleviate shoulder pain stemming from conditions like shoulder arthritis, rotator cuff injuries, or other shoulder problems. 

This procedure targets the suprascapular nerve surrounding the shoulder. Suprascapular nerve blocks can alleviate some shoulder pain and enable you to effectively engage in rehabilitation and physical therapy, leading to longer-term relief.