Suprascapular Nerve Blocks

 

 

What is the Suprascapular Nerve?

The suprascapular nerve is the major sensory supply to the shoulder joint and motor supply to the Supraspinatus and infraspinatus muscles.

The suprascapular nerve supplies sensory fibers to about 70% of the shoulder joint, including the superior and posterosuperior regions of the shoulder joint and capsule.

When is a Suprascapular Nerve Block required?

Suprascapular nerve block is a safe and effective treatment for chronic shoulder pain. It is known to remarkably improve pain, disability and range of movement at the shoulder.

The suprascapular nerve block is used to treat arthritis or bursitis of the shoulder joint. A suprascapular is normally administered for the following two purposes:

Diagnostic

The suprascapular nerve block is termed as ‘diagnostic’ if it is given to confirm suprascapular nerve irritation or entrapment. The purpose is fulfilled if the injection brings about immediate pain relief.

Therapeutic:

This category of injection is given with the aim of providing relief from pain and related symptoms.

 

Recent studies indicate that a suprascapular nerve block is also a new concept for the management of frozen shoulder of reflex sympathetic dystrophy. This finding is further based on the fact that the nerve contains a high proportion of sympathetic fibers supplying the shoulder joint.

If you get temporary pain relief from this procedure, you may be further advised to undergo a radiofrequency lesioning of the suprascapular nerve. This procedure comparatively offers a longer lasting relief from pain.

What is the procedure?

The procedure can be performed either by using direct imaging .i.e. CT guided or in the clinic using anatomical landmarks to determine needle placement.

The procedure for administering a suprascapular nerve block generally follows the below listed steps:

  1. The patient is clearly explained all the aspects of the procedure, along with the possible risks and side effects. A consent form is signed to confirm his approval. Where required, the patient’s medical history will also be discussed to ensure that no adverse factors are present.
  2. After the patient has taken his position, an IV is started, so that he can be administered some relaxation medicine.
  3. Once done, the area to be injected is cleaned with sterile scrub.
  4. Using x-ray guidance, the physician will then insert a needle through the skin and deeper tissues. The injection contains a mixture of a local anesthetic and steroid.

In some cases, patients are also given an intravenous sedation to make the procedure pain-free and easy to tolerate.

Research suggests that a suprascapular nerve block with bupivacaine and methylprednisolone acetate is a safe and result-oriented treatment for shoulder pain in patients with degenerative disease and arthritis.

After the procedure is over, the patient will be monitored for a minimum of 30 minutes.