Evaluation of internally cooled radiofrequency ablation targeting multiple shoulder nerves for chronic shoulder pain relief and function restoration: a prospective study

• Published in: Pain medicine (Malden, Mass.) Vol. 26; no. 7; pp. 397 - 406
• Main Authors: Yoshida, Mitsukuni, Park, Peter K, Thang, Loc V
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2025
• Subjects: Adult; Aged; Chronic Pain - surgery; Chronic Pain - therapy; Female; Humans; Interventional Pain & Spine Medicine Section; Male; Middle Aged; Pain Measurement; Prospective Studies; Radiofrequency Ablation - methods; Range of Motion, Articular - physiology; Recovery of Function; Shoulder Pain - surgery; Shoulder Pain - therapy; Treatment Outcome; radiofrequency ablation; shoulder pain; functional outcomes
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1093/pm/pnaf016

Shoulder pain is a prevalent musculoskeletal disorder, affecting up to 70% of adults over their lifetimes. Recently, radiofrequency ablation (RFA) has gained attention as a treatment for joint pain. This study aims to evaluate the efficacy of internally cooled RFA (icRFA) in alleviating shoulder pain and improving both qualitative and quantitative measures of shoulder function. Prospective cohort study. Patients with chronic shoulder pain (n = 35) who responded positively to diagnostic blocks of the suprascapular nerve (SSN), axillary nerve (AN), and lateral pectoral nerve (LPN). Patients underwent icRFA targeting the SSN, AN, and LPN. Treatment response was assessed with the numeric rating scale (NRS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (AROM) in flexion and abduction. Outcomes were measured at baseline and at 1, 3, and 6 months after icRFA. Patient characteristics were compared between responders and nonresponders to icRFA treatment, and correlation analyses were conducted to explore the relationship between pain relief and functional improvement. NRS pain levels significantly decreased at 1 month (Adjusted [Adj.] P < .0001), 3 months (Adj. P < .0001), and 6  months (Adj. P = .0002) after icRFA. ASES score improved at 1 month (Adj. P < .0001), 3 months (Adj. P < .0001), and 6 months (Adj. P < .0001) after icRFA. Flexion AROM improved at 1 month (Adj. P < .0001), 3 months (Adj. P < .0001), and 6 months (Adj. P = .0139) after icRFA. Abduction AROM improved at 1 month (Adj. P < .0001), 3 months (Adj. P < .0001), and 6 months (Adj. P < .0001) after icRFA. iccRFA targeting the SSN, AN, and LPN is a safe and effective intervention, providing significant improvements in pain, functional activities of daily living, and AROM of the shoulder for at least 6 months.