The shoulder is one of the most complex joints in the body. It allows a wide range of motion thanks to its unique structure:
- Glenohumeral joint: between the head of the humerus (arm bone) and the glenoid cavity of the scapula.
- Rotator cuff muscles: supraspinatus, infraspinatus, subscapularis, and teres minor, which stabilize and move the shoulder.
- Tendons, ligaments, and bursae: structures that help protect and facilitate movement.
- Innervation: the suprascapular nerve (70% of sensitivity) and other brachial plexus nerves.
Why Does it Hurt?
There can be multiple causes of shoulder pain:
- Tendinitis and bursitis: inflammation of tendons or synovial bursae.
- Osteoarthritis: age-related joint wear.
- Rotator cuff injuries
- Instability or dislocation
- Referred pain (from other structures such as the neck or chest)
- Neurological or postural conditions.
How is the Diagnosis Made?
The diagnosis is based on:
- Clinical examination
- Ultrasound, X-ray, or magnetic resonance imaging
- Diagnostic tests such as suprascapular nerve block (considered positive if it reduces pain by at least 50%)
Available Treatments
Conservative Approach
- Physical therapy and exercises to improve strength and mobility
- TENS (Transcutaneous Electrical Nerve Stimulation): small electrical impulses that help reduce pain
- Medications: anti-inflammatory drugs, painkillers
Regular movement, within the limits of your pain, is essential. Alternating activity and rest, getting good sleep, and using relaxation techniques (such as yoga or meditation) can reduce symptoms.
Interventional Treatments
- Joint injections
- Suprascapular nerve blocks under ultrasound guidance* LINK TO Diagnostic Suprascapular Nerve Block
- Pulsed Radiofrequency (PRF) under ultrasound guidance: minimally invasive technique to modulate pain. According to a study in the Brazilian Journal of Anesthesiology (2021), PRF of the suprascapular nerve led to:
- Pain reduction for up to 6 months
- Improved movement
- High patient satisfaction
