Efficacy of pulsed radiofrequency on the suprascapular and axillary-circumflex nerve for shoulder pain: A randomised controlled trial

Abstract

Background and Aims: Painful shoulder is one of the most frequent consultation causes. Multiple treatments have been described to relieve pain, restore range of motion and improve functionality. Methods: This randomised clinical trial was conducted in 60 patients. The treatment group received combined pulsed radiofrequency (PRF) on suprascapular nerve (SN) and axillary-circumflex nerve (ACN). The control group received PRF on SN only. The primary outcome was pain intensity measured by the Numerical Rating Scale (NRS). The secondary outcomes were the Shoulder Pain and Disability Index (SPADI), the Constant–Murley range of motion scale and Disability of the Arm, Shoulder and Hand (DASH) scale. The patients were monitored at the baseline visit and at 1, 3, 6 and 9 months. A mixed ordinal regression model was estimated to evaluate the association between the study group and pain measured with NRS. Results: A global decrease in pain at the end of the study was noted. The global baseline NRS was 8.4, and the global final NRS at 9 months of follow-up was 6.2. Combined PRF on SN and ACN was not associated with lower NRS pain scores compared to single SN PRF [odds ratio (OR) =1.04, 95% confidence interval (CI) 0.91–1.20, P = 0.507]. Secondary outcomes showed no significant differences: SPADI (OR = 1.04, 95% CI 0.92–1.18), Constant–Murley (OR = 1.01, 95% CI 0.90–1.14), DASH (OR = 1.04, 95% CI 0.92–1.17). Conclusion: Combined PRF applied to SN and ACN was not superior to PRF applied to SN alone.

Keywords

• axillary-circumflex nerve
• pulsed radiofrequency
• shoulder pain
• shoulder pain and disability index
• suprascapular nerve