Suprascapular Nerve Block

A suprascapular nerve block (SSNB) is a medical procedure that treats shoulder pain caused by various chronic conditions. The technique involves injecting anesthetic into the affected shoulder, targeting the suprascapular nerve, which plays a crucial role in providing motor innervation to shoulder muscles, and sensory branches to various areas in the shoulder region. This procedure is considered safe and can be beneficial for managing discomfort due to chronic shoulder issues.

What is a Suprascapular Nerve Block?

A suprascapular nerve block, also known as a suprascapular nerve injection or suprascapular nerve blockade, is an outpatient procedure designed to alleviate pain and discomfort resulting from conditions like arthritis, bursitis, or impingement of the suprascapular nerve in the shoulder joint. It involves injecting numbing medicine into the shoulder to block pain signals from the suprascapular nerve, a major motor nerve that serves the shoulder muscles.

The suprascapular nerve, formed from nerve fibers of C4, C5, and C6 nerve roots, is a crucial sensory and motor supplier to the shoulder, impacting the supraspinatus and infraspinatus muscles. If noninvasive treatments are insufficient in managing your shoulder pain, a suprascapular nerve block is often the best treatment to provide relief.

Why is a Suprascapular Nerve Block Performed?

Suprascapular nerve block treats acute shoulder pain. It is also an effective way to diagnose and aid chronic shoulder issues, including bursitis, arthritis, impingement syndrome, frozen shoulder (adhesive capsulitis), and degenerative joint and rotator cuff tears. Studies indicate that local anesthetics and steroids can alleviate pain and disability caused by certain chronic shoulder pain conditions. The procedure is a safe and highly effective way to improve shoulder functionality and reduce pain.

How to Prepare for a Suprascapular Nerve Block

To prepare for a suprascapular nerve block, complying with the following steps is essential. Certain medications may cause complications, so it's important to stop taking blood-thinning drugs based on your physician's instructions. However, you can take most of your usual medications with a sip of water on the morning of the procedure unless advised otherwise. It's crucial to disclose all current medications you are taking and inform your healthcare team if a pregnancy is possible.

You also must follow the fasting guidelines provided by your healthcare administrator and avoid eating, drinking, smoking, or chewing before the procedure. If you are an insulin dependent diabetic you will always be at the top of the list. Please bring your insulin with you and it will be administered to you following your procedure.

Lastly, since you won't be able to drive for 24 hours following your visit, arrange for a friend or family member to drive you home after your suprascapular nerve block. Adhering to these necessary precautions will ensure a safe and effective recovery process.

What Happens During a Suprascapular Nerve Block?

A suprascapular nerve block is a simple, straightforward procedure:

  1. Preparation: You will sit or lie down, and a physician will clean the shoulder blade area with an antiseptic collusion. Your doctor will then numb the skin or tissue with local anesthesia. Sometimes, you may use intravenous sedation for a pain-free procedure.
  2. Needle Placement and Insertion: A large needle is gently inserted through the numbed tissue and guided to the suprascapular nerve. There are several methods your physician will use to guide the needle, including ultrasound or a fluoroscope (video x-ray device). A contrast dye may be injected to ensure precise needle placement using a fluoroscope.
  3. Test and Main Injections: A small amount of numbing medicine is injected as a test, and pain relief indicates that the suprascapular nerve is the source of pain. If the test is successful, medicine to block pain and reduce inflammation is injected for long-lasting relief.
  4. Finishing Procedure: A small bandage is applied to the skin, and you will wait for a brief period to confirm there are no adverse effects. The procedure typically only takes 15-30 minutes, and If everything looks good, you can go home immediately after the procedure. Total relief may take several days, or up to six weeks.

Are There Risks Associated with a Suprascapular Nerve Block?

Although complications are generally uncommon, there are certain risks you should know about before deciding to have a suprascapular nerve block:

  • Temporary increase of pain for up to two weeks after the procedure. You may also experience numbness or weakness in your arms for a few hours following the injection.
  • Although we will sterilize the injection site, there is always a slight chance of infection where the needle is inserted.
  • There may be a risk of bleeding or bruising, especially if you regularly take blood thinners or similar medication.
  • Risk of damaged tissues near the injection area and, very rarely, a permanent increase of pain, soreness, or bruising at the injection site.
  • Because the injection is administered over the chest area, there is a small risk of puncturing the lung lining, potentially causing air to collect around the lungs. Seek immediate medical attention if you experience severe sharp pain upon deep breaths or breathlessness following the injection.
  • The steroids may temporarily raise blood sugar levels in diabetic patients.
  • Local anesthetic toxicity or adverse reactions to the steroid medication may occur. Side effects from the steroid medication may include hyperglycemia, altered menstrual cycle, fluid retention, insomnia, sweats, hot/cold flashes, flushed face, weight gain, epidural lipomatosis, steroid myopathy, avascular necrosis of bone, osteoporosis, and Cushing's syndrome.

Post Suprascapular Nerve Block and Recovery

Following your suprascapular nerve block procedure, you can leave the hospital the same day, once you're cleared by your physician. You will need someone to drive you home, but you can resume driving by the next day. You may also resume light activities the same day and will begin physical therapy after 24 hours.

To manage pain, apply ice packs to the shoulder for 20 minutes per hour and take over-the-counter Tylenol and Motrin. Take it easy the next few days and gradually increase regular activities, but be mindful of your shoulder. You can take daily walks, use an exercise bike, or swim on your back for exercise.

Showering is allowed on the same day as the procedure, but refrain from submerging or swimming in water for 24 hours. Keep the bandage on for a day, and refrain from scrubbing the incision spot. Do not apply lotions or creams, and avoid hot tubs and pools, as they can cause infection. Seek immediate medical attention if you experience severe pain, shortness of breath, or unusual symptoms. Schedule a follow-up visit in 2-4 weeks following your suprascapular nerve block.

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