Clinical Report: Internally Cooled Radiofrequency Ablation for Chronic Shoulder Pain

Overview

This prospective study evaluated internally cooled radiofrequency ablation (icRFA) targeting the suprascapular, axillary, and lateral pectoral nerves in 35 patients with chronic shoulder pain. Significant reductions in pain and improvements in shoulder function and active range of motion were observed at 1, 3, and 6 months post-treatment.

Background

Shoulder pain is a common musculoskeletal disorder affecting up to 70% of adults during their lifetime and often results from osteoarthritis or rotator cuff pathology. Conventional treatments include physical therapy, steroid injections, and surgery, but these have limitations such as variable efficacy and adverse effects. Radiofrequency ablation (RFA) has emerged as a promising alternative, with recent studies focusing on targeting nerves innervating the shoulder joint to reduce pain while preserving motor function. Internally cooled RFA (icRFA) may offer enhanced outcomes by targeting multiple nerves simultaneously.

Data Highlights

Key Findings

• Internally cooled RFA targeting the suprascapular, axillary, and lateral pectoral nerves significantly reduced shoulder pain at 1, 3, and 6 months post-treatment.
• Functional improvement measured by the American Shoulder and Elbow Surgeons (ASES) score was significant and sustained through 6 months.
• Active range of motion in shoulder flexion and abduction improved significantly at all post-treatment time points.
• The procedure was safe with no reported adverse effects compromising motor function.
• Targeting multiple nerves simultaneously may enhance pain relief and functional outcomes compared to single nerve approaches.

Clinical Implications

Internally cooled RFA offers a safe and effective interventional option for patients with chronic shoulder pain unresponsive to conventional treatments. By targeting multiple articular nerves, icRFA can provide sustained pain relief and functional improvement, potentially reducing reliance on steroids or surgery. Clinicians should consider icRFA as part of a multimodal management strategy for shoulder pain.

Conclusion

This study supports the use of internally cooled RFA targeting the suprascapular, axillary, and lateral pectoral nerves as a viable treatment to alleviate chronic shoulder pain and improve function for at least six months. Further research may optimize patient selection and long-term outcomes.

References

1. Eckmann et al. 2020 -- Utility of icRFA for Shoulder Pain
2. Orhurhu et al. 2019 -- Systematic Review of RFA for Shoulder Pain
3. Pushparaj et al. 2021 -- Meta-analysis of pRFA vs Medical Management
4. Santi et al. Recent -- Retrospective Analysis of icRFA Targeting SSN, AN, LPN