ABSTRACT
Background and Objective
Studies have reported relief of chronic shoulder pain with non‐ablative pulsed neuromodulatory [pRF] or ablative radiofrequency [aRF] procedures on innervation of the shoulder joint but interpretation of these reports is hampered by inconsistent indications, anatomic targets, and follow‐up. This systematic review was conducted to synthesize the existing literature on procedures employing pRF or aRF for treating chronic shoulder pain.
Databases and Data Treatment
MEDLINE and other medical literature databases were reviewed up to December 31, 2019 for publications on pRF or aRF procedures on shoulder joint innervation to relieve chronic pain. Data on analgesic and functional outcomes measured at any time point following the interventions were extracted. Existing knowledge on innervation of the shoulder joint with relevance to RF procedures was also synthesized.
Results
Forty‐two publications, seven randomized controlled trials [RCTs] and 35 observational studies, case series or reports were identified. Thirty‐six of these publications were on pRF procedure and 29 of these reported procedures exclusively targeting the suprascapular nerve. A meta‐analysis of the seven RCTs evaluating pRF indicated no analgesic benefit or functional improvement with this treatment over conventional medical management. Case series and reports on aRF indicate a potential for analgesic benefit but the quality of this evidence was low.
Conclusions
RF treatments targeting the sensory innervation of the shoulder joint affected by degenerative conditions have the potential to reduce pain but the current evidence does not suggest analgesic or functional benefit (GRADE certainty of evidence ‐ low). Studies of high methodological quality are required to further investigate the role of these interventions.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/39109y4
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