Shoulder Pain

Suprascapular Nerve Block

Chronic shoulder pain can be burdensome, but here at Solutions In Pain this chronic shoulder pain can be treated with excellent precision & efficacy through blocking the pain signals associated with chronic shoulder pain. These pain signals travel across the sensory suprascapular nerve. Therefore our clinic offers a procedure known as Suprascapular Nerve Block: a short 10-15 minute procedure where we can effectively target these suprascapular nerves with our injectable anesthetic and steroid medications which can thereby substantially reduce the pain of those suffering from chronic shoulder pain.

Clinical Indications For This Procedure:

  • Chronic Shoulder Pain
  • Failed Shoulder Surgery
  • Non-Surgical Candidates
  • Suprascapular Neuropathy
  • Other Neuropathic Disorders

What To Expect From Your Procedure
You will arrive at our clinic 15 minutes prior to your appointment with or without a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form and you will subsequently be positioned in preparation for the procedure.

An antiseptic alcohol solution will then be used to clean the site of injection & surrounding skin to help decrease chances of infection. The procedure site will then be identified under ultrasound guidance. Once the site is appropriately identified an injection of a numbing medication called lidocaine will be administered to numb the site of injection & surrounding skin. Once the lidocaine has settled the suprascapular nerve will receive an injection cocktail consisting of an anesthetic (bupivacaine) and a steroid (kenalog). This cocktail disperses and bathes the nerves providing optimal pain relief with most of our patients reporting significant & immediate relief of their chronic shoulder pain. You will then be observed for an additional 10-15 minutes following completion of the procedure to ensure your safety and then scheduled for post-procedural follow up by our staff.

What To Expect After Procedure

  • Substantial reduction in shoulder pain
  • Improved mobility, range of motion, and activity of the shoulder
  • Pain relief ranging from days to months
  • Acute short term mild swelling or pain around the injection site

Risks Associated With Suprascapular Nerve Block

  • Misplacement of the needle
  • Unexpected bleeding
  • Drug allergies
  • Infection
  • Nerve damage
  • Worsening pain
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Suprascapular Radiofrequency Ablation (RFA)

Chronic shoulder pain can be burdensome, but here at Solutions In Pain this chronic shoulder pain can be treated with excellent precision & efficacy through blocking the pain signals associated with chronic shoulder pain. These pain signals travel across the sensory suprascapular nerve. Therefore our clinic offers patients who have demonstrated significant improvement in shoulder pain following a minimum of two Suprascapular Nerve Block treatments a remarkable procedure known as Suprascapular Radiofrequency Ablation (RFA): a short 10-15 minute procedure where we can effectively target these suprascapular nerves with a carefully delivered electric current produced by a radio wave. This electric current heats a small area of the nervous tissue where pain signals are created and this allows us to effectively block or interrupt the signals that cause pain from communicating with the brain thereby substantially reducing the pain of those who suffer from chronic shoulder pain.

Clinical Indications For This Procedure:

  • Chronic Shoulder Pain
  • Failed Shoulder Surgery
  • Non-Surgical Candidates
  • Suprascapular Neuropathy
  • Other Neuropathic Disorders
  • Successful Completion Of Serial Suprascapular Nerve Blocks With Clinically Satisfactory Results

What To Expect From Your Procedure
You will arrive at our clinic 15 minutes prior to your appointment with a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form and you will subsequently be positioned in preparation for the procedure.

Chloraprep will then be used to clean the procedural site & surrounding skin to help decrease chances of infection. The procedure site will then be identified under fluoroscopic guidance. Once the site is appropriately identified an injection of a numbing medication called lidocaine will be administered to numb the procedural site & surrounding skin. Once the lidocaine has settled the suprascapular nerves will be injected with a cocktail consisting of anesthetic (bupivacaine) and steroid (kenalog). This cocktail disperses and bathes the nerves & surrounding structures providing optimal pain relief for the following radiofrequency ablation. Once the medications have settled in we will proceed with radiofrequency ablation. This process will only take a few minutes. Following completion of the procedure you will then be assessed & observed for an additional 10-15 minutes following completion of the procedure to ensure your safety and then scheduled for post-procedural follow up by our staff.

What To Expect After Procedure

  • Substantial reduction in shoulder pain
  • Improved mobility, range of motion, and activity of the shoulder
  • Pain relief ranging from days to 3-12 months
  • Acute short term mild swelling or pain around the injection site

Risks Associated With Suprascapular Radiofrequency Ablation (RFA)

  • Misplacement of the needle
  • Unexpected bleeding
  • Drug allergies
  • Infection
  • Nerve damage
  • Worsening pain
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Peripheral Nerve Stimulator (PNS)

Chronic shoulder pain is burdensome and even more so for the individual patients who have exhausted various modalities of treatment with minimal to no success. These treatments include, but are not limited to physical therapy, prescription medications, genicular nerve blocks, radiofrequency ablation, or surgical interventions. However, at Solutions In Pain we offer these treatment resistant patients the implantation of cutting edge medical devices such as the Peripheral Nerve Stimulator (PNS).

Clinical Indications For This Procedure:

  • Chronic Shoulder Pain
  • Failed Shoulder Surgery
  • Non-Surgical Candidates
  • Neuropathic Disorders
  • Failed Multiple Treatment Modalities Including: Physical Therapy, Medications, Suprascapular Nerve Blocks, Suprascapular RFA, And/Or Surgical Interventions

What Is A Peripheral Nerve Stimulator (PNS) ?
Chronic shoulder pain like all pain is reliant on the intimate communication between the nerves and our brain. However, these pain signals that travel along the nerves in our body can be treated with excellent precision & efficacy by interrupting or blocking the communication of pain signals associated with chronic shoulder pain. Therefore our clinic through the courtesy of cutting edge medical device companies offers the the surgical implantation of a Peripheral Nerve Stimulator (PNS): a pace-maker like device that is implanted under the skin which through neuromodulation is able to deliver mild electrical impulses which can substantially reduce the pain of those suffering from chronic shoulder pain. Moreover, the device has remote control capabilities allowing patients to control their pain with remarkable precision using the flexible intensity & location parameters of the device.

What To Expect From Your Procedure
A. The Preoperative Phase
We will perform preoperative assessment and order psychiatric clearance at which point you will be referred to a psychiatrist who will evaluate your medical history, family history, psychological history, and history of substance abuse if relevant. Furthermore, the psychiatrist will ask you questions regarding your chronic shoulder pain, how it impacts your everyday life, and how the pain has affected you both physically & emotionally.

B. The Trial Phase
You will arrive at our clinic 15 minutes prior to your appointment with a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form and you will subsequently be positioned in preparation for the procedure.

Chloraprep will then be used to clean the procedural site & surrounding skin to help decrease chances of infection. The procedure site will then be identified under fluoroscopic guidance. Once the site is appropriately identified an injection of a numbing medication called lidocaine will be administered to numb the procedural site & surrounding skin. Then trial electrodes will then be introduced into the procedure site via small needles which are then connected to an external battery and programmer. You will then be observed for an additional 10-15 minutes following completion of the procedure to ensure your safety. After you have been monitored you will then be provided device use/care as well as wound care discharge instructions from your provider along with a prescription for a short course prophylactic antibiotic. Following discharge education you will then be scheduled for postoperative follow up by our staff. Trial phase is 5-7 days in duration.

C. The Implantation Phase
At the date of your postoperative follow up visit you will be thoroughly evaluated regarding your experiences with respect to the trial phase. If you had positive experiences with substantial pain relief during the trial phase we will recommend proceeding with the implantation phase. At which point you may decide whether or not to move forward with permanent implantation at our surgical center.

You will arrive at our surgical center 15-30 minutes prior to your appointment with your designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form as well as other necessary documentation and you will subsequently be positioned in preparation for the procedure. Following implantation you will be discharged with device use/care and wound care discharge instructions along with any postoperative medications at the discretion of your provider.

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Trigger Point Injection

Chronic shoulder pain is burdensome. However, for the patient’s whose shoulder pain primarily has muscular contributions this chronic shoulder pain and associated tension or spasms can be treated with excellent precision & efficacy by helping to target inflammation, nerve irritation, and other inflammatory processes in the body that contribute to muscular pain and tension. Therefore our clinic offers a procedure known as Trigger Point Injection: a short 10-15 minute procedure where we can effectively target these problematic muscles & associated tension with our injectable anesthetic medications which can thereby substantially reduce the pain of those suffering from chronic shoulder pain.

Clinical Indications For This Procedure:

  • Muscular Spasms
  • Myofascial Pain Syndrome (MPS)
  • Positive Identification Of Trigger Points On Physical Examination

What To Expect From Your Procedure
You will arrive at our clinic 15 minutes prior to your appointment with or without a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form and you will subsequently be positioned in preparation for the procedure.

An antiseptic alcohol solution will then be used to clean the site of injection & surrounding skin to help decrease chances of infection. The procedure site will then be identified under ultrasound guidance. Once the site is appropriately identified an injection of a numbing medication called lidocaine will be administered to numb the site of injection & surrounding skin. Once the lidocaine has settled the injection consists of an anesthetic (bupivacaine). This cocktail disperses and bathes the surrounding nerves & affected joints providing optimal pain relief with most of our patients reporting significant & immediate relief of their chronic muscular pain & associated tension or spasms. You will then be observed for an additional 10-15 minutes following completion of the procedure to ensure your safety and then scheduled for post-procedural follow up by our staff.

What To Expect After Procedure

  • Substantial reduction in chronic shoulder pain
  • Substantial reduction in muscle tension
  • Substantial reduction in muscle spasms
  • Improved mobility, range of motion, and activity of the shoulder
  • Pain relief ranging from days to months
  • Acute short term mild swelling or pain around the injection site

Risks Associated With Trigger Point Injection

  • Misplacement of the needle
  • Unexpected bleeding
  • Drug allergies
  • Infection
  • Nerve damage
  • Worsening pain
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