Clinical Scorecard: Assessment of Internally Cooled Radiofrequency Ablation for Targeting Multiple Nerves in the Shoulder to Alleviate Chronic Pain and Enhance Function: A Prospective Investigation

At a Glance

Key Highlights

• icRFA significantly reduces numeric rating scale (NRS) pain scores at 1, 3, and 6 months post-treatment
• Functional improvement demonstrated by increased American Shoulder and Elbow Surgeons (ASES) scores and active range of motion (AROM) in flexion and abduction
• Treatment targets multiple nerves (SSN, AN, LPN) to maximize pain relief and functional gains while preserving motor function

Guideline-Based Recommendations

Diagnosis

• Confirm chronic shoulder pain diagnosis with positive response to diagnostic nerve blocks of suprascapular, axillary, and lateral pectoral nerves

Management

• Consider icRFA targeting SSN, AN, and LPN for patients with chronic shoulder pain refractory to conservative treatments
• Use multimodal approach including physical therapy and pharmacotherapy as appropriate

Monitoring & Follow-up

• Assess pain levels using numeric rating scale (NRS) at baseline and follow-up intervals (1, 3, 6 months)
• Evaluate functional outcomes with American Shoulder and Elbow Surgeons (ASES) score and active range of motion (AROM)

Risks

• Avoid motor nerve injury by targeting articular branches and adhering to safe anatomic zones during icRFA
• Monitor for potential adverse effects related to procedure though icRFA is generally safe

Patient & Prescribing Data

Patients with chronic shoulder pain responsive to diagnostic nerve blocks of SSN, AN, and LPN

icRFA provides significant pain relief and functional improvement lasting at least 6 months, representing a safe alternative to steroid injections and surgery

Clinical Best Practices

• Perform diagnostic nerve blocks to identify appropriate nerve targets prior to icRFA
• Target multiple nerves (SSN, AN, LPN) to optimize pain relief and functional outcomes
• Use internally cooled RFA technology to enhance lesion size and efficacy while minimizing thermal injury
• Monitor patients longitudinally with standardized pain and function assessments
• Incorporate icRFA as part of a multimodal treatment plan for chronic shoulder pain

References

• Orhurhu et al. 2019 Systematic Review on RFA for Shoulder Pain
• Pushparaj et al. 2021 Systematic Review and Meta-analysis on pRFA
• Eckmann et al. 2020 Case Series on icRFA Targeting SSN, AN, LPN
• Santi et al. Retrospective Analysis of icRFA Effectiveness