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Meta-Analysis
. 2023 Sep;105(7):589-598.
doi: 10.1308/rcsann.2022.0026. Epub 2022 Aug 17.

Suprascapular nerve blockage for painful shoulder pathology - a systematic review and meta-analysis of treatment techniques

T J Batten  1 , J P Evans  1   2 , E G Burden  1 , W K Mak  1 , W White  1 , C D Smith  1
Affiliations
Meta-Analysis

Suprascapular nerve blockage for painful shoulder pathology - a systematic review and meta-analysis of treatment techniques

T J Batten et al. Ann R Coll Surg Engl. 2023 Sep.

Abstract

Background: Suprascapular nerve blockade (SSNB) through injection (SSNBi) and/or pulsed radiofrequency (PRF) provide options for the management of painful shoulder pathology. Multiple techniques for delivery of SSNB are described but no consensus on optimal symptom control is available. This systematic review and meta-analysis aims to assess patient-focussed outcomes in SSNB and explore the impact of variation in the technical application of this treatment modality.

Methods: MEDLINE, Embase and CINAHL were searched for case series, cohort studies and randomised control trials published from database inception until 28 January 2021. Articles reporting use of SSNBi or PRF for treatment of shoulder pain with a minimum 3 months follow-up were included. Patient-reported outcome measures (PROMs) were extracted and the pooled standardised mean difference (SMD), weighted by study size, was reported. Quality of methodology was assessed using Wylde's nonsummative four-point system.

Findings: Of 758 references, 18 studies were included, totalling 704 SSNB. Average pain improvement at 3 months was 52.3%, with meta-analysis demonstrating a SMD of 2.37. Whereas SSNBi combined with PRF shows the greatest SMD of 2.75, this did not differ significantly from SSNBi or PRF when used as monotherapy. Location of treatment and the guidance technique used did not influence outcome.

Conclusion: SSNBi and PRF provide safe and effective treatment for shoulder pain, as judged by PROMs. This may be of particular value in aging or comorbid patients and with surgical restrictions during the COVID-19 pandemic. Regardless of technique, patients experience a marked improvement in pain that is maintained beyond 3 months.

Keywords: Nerve block; Pain; Suprascapular nerve.

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Conflict of interest statement

The Authors declare that there is no conflict of interest. All authors had full access to all the data in the study, and had final responsibility for the decision to submit for publication.

Figures

Figure 1
Figure 1
PRISMA flow diagram of search
Figure 2
Figure 2
Meta-analysis by type of treatment modality
Figure 3
Figure 3
Meta-analysis by guidance technique
Figure 4
Figure 4
Meta-analysis by location of treatment
See this image and copyright information in PMC

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