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.