The efficacy of pulsed radiofrequency stimulation of the glenohumeral joint and suprascapular nerve for chronic shoulder pain and function compared to physiotherapy and exercise program without pain management

Abstract

Background: Degenerative tendon diseases are primarily treated conservatively in primary health care and the most important treatment modality is physiotherapy-guided therapeutic rehabilitation. Method: In this prospective observational study, we investigated the effect of two different treatment approaches in patients with chronic shoulder pain. Physiotherapy-guided treatment was compared to interventional pain treatment with radiofrequency nerve stimulation (pRF) before exercise therapy. The primary outcomes were active shoulder mobility and shoulder function assessed by SPADI questionnaire at two and 6-month controls. Results: The results of this study show that pRF treatment combined to physiotherapy seem to effect shoulder function more than physiotherapy alone. With regard to patients with chronic pain and decreased shoulder mobility (65%), pRF treatment showed a significant greater effect in relieving pain and increasing functional outcome assessed by SPADI. Also short-term pain and impairment reduction for 8-12 weeks occurred in patients with chronic rotator cuff lesions. A direct comparison between the rehabilitation programs strengthened the assumption that effective pain management could be necessary to obtain optimal effect of physiotherapy and physical training in patients with chronic (> 3 months) shoulder pain. Conclusion: PRF can be performed in an outpatient department and provides the clinician with an alternative or additional approach to oral drug treatment and intra-articular injection. Further, it may prove to be a useful treatment for patients who are unfit or unwilling to consider surgical intervention Level of evidence: IV.