Notch vs Midpoint Suprascapular Nerve PRF for Chronic Shoulder Pain
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: PRF of the Suprascapular Nerve (Notch Approach), PRF of the Suprascapular Nerve (Midpoint Approach).
- Who it may be relevant to
- Registry conditions: Chronic Shoulder Pain, Rotator Cuff Tendinopathy. Basic parameters: 40 years — 80 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Comparison of Suprascapular Notch and Midpoint Approaches in Pulsed Radiofrequency Treatment of the Suprascapular Nerve on Pain and Function in Patients With Chronic Shoulder Pain
Overview
This study aims to compare the effects of pulsed radiofrequency (PRF) treatment of the suprascapular nerve using suprascapular notch and midpoint approaches on pain, shoulder function, and muscle strength in patients with chronic shoulder pain due to rotator cuff tendinopathy. Patients will be randomly assigned to one of the two intervention groups. Clinical evaluations will include pain assessment using the Numeric Rating Scale (NRS), functional assessment using the Shoulder Pain and Disability Index (SPADI), and quality of life assessment using the Short Form-36 (SF-36). In addition, shoulder range of motion will be measured goniometrically, muscle thickness of the supraspinatus and infraspinatus will be evaluated by ultrasonography, and shoulder muscle strength will be assessed using an isokinetic dynamometer. Assessments will be performed at baseline, 24 hours, 1 month, and 3 months after the intervention. The results of this study are expected to provide evidence regarding the optimal approach for PRF treatment of the suprascapular nerve in patients with chronic shoulder pain.
Detailed description
Chronic shoulder pain is a common musculoskeletal condition that significantly affects daily activities and quality of life. Rotator cuff tendinopathy is one of the most frequent causes of chronic shoulder pain. The suprascapular nerve plays a key role in shoulder pain transmission, and pulsed radiofrequency (PRF) of the suprascapular nerve has emerged as an effective minimally invasive treatment option.
Different anatomical approaches have been described for suprascapular nerve interventions, including the suprascapular notch and midpoint approaches. However, there is limited evidence comparing the clinical and functional outcomes of these approaches.
The aim of this prospective, randomized study is to compare the effects of PRF applied to the suprascapular nerve via suprascapular notch and midpoint approaches in patients with chronic shoulder pain due to rotator cuff tendinopathy. Patients will be randomly allocated into two groups according to the intervention approach.
Clinical evaluations will include pain assessment using the Numeric Rating Scale (NRS), functional evaluation using the Shoulder Pain and Disability Index (SPADI), and quality of life assessment using the Short Form-36 (SF-36). In addition, shoulder range of motion will be measured goniometrically. Muscle thickness of the supraspinatus and infraspinatus will be assessed using ultrasonography, and shoulder muscle strength will be evaluated using an isokinetic dynamometer.
Assessments will be performed at baseline, 24 hours, 1 month, and 3 months following the intervention. The primary outcome of the study is the change in shoulder muscle strength, while secondary outcomes include pain, functional status, and muscle thickness.
The findings of this study are expected to contribute to the literature by identifying the optimal anatomical approach for suprascapular nerve PRF in the management of chronic shoulder pain.
Interventions
- Procedure PRF of the Suprascapular Nerve (Notch Approach)
Under ultrasound guidance, a radiofrequency needle will be positioned adjacent to the suprascapular nerve at the suprascapular notch. Sensory stimulation at 50 Hz and motor stimulation at 2 Hz will be performed to confirm appropriate needle placement. Pulsed radiofrequency will then be applied at 42°C for three cycles of 120 seconds. - Procedure PRF of the Suprascapular Nerve (Midpoint Approach)
Under ultrasound guidance, a radiofrequency needle will be positioned adjacent to the suprascapular nerve at the midpoint between the suprascapular notch and the spinoglenoid notch. Sensory stimulation at 50 Hz and motor stimulation at 2 Hz will be performed to confirm appropriate needle placement. Pulsed radiofrequency will then be applied at 42°C for three cycles of 120 seconds.
Primary outcome measures
- Isokinetic Shoulder Abduction Peak Torque [Time frame: Baseline and 3 months]
Secondary outcome measures (5)
- Pain Intensity (NPRS) [Time frame: Baseline, 24 hours, 1 month, and 3 months]
- Shoulder Function (SPADI) [Time frame: Baseline, 1 month, and 3 months]
- Supraspinatus and Infraspinatus Muscle Thickness [Time frame: Baseline and 3 months]
- Shoulder Range of Motion (ROM) [Time frame: Baseline and 3 months]
- Quality of Life (SF-36) [Time frame: Baseline and 3 months]
Eligibility criteria
Inclusion criteria
- Patients aged between 40 and 80 years
- Patients with chronic shoulder pain lasting longer than 3 months
- Patients diagnosed with rotator cuff-related shoulder pain
- Patients who show at least 50% pain reduction after diagnostic suprascapular nerve block
- Patients who provide written informed consent
Exclusion criteria
- Adhesive capsulitis
- Previous shoulder surgery
- Full-thickness rotator cuff tear
- Neurological disorders affecting the shoulder
- Pacemaker
- Coagulopathy or anticoagulant therapy contraindicating intervention
- Infection at the injection site
- Severe systemic disease
- Pregnancy
- Inability to comply with study protocol
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
Turkey (Türkiye) · 1 center
- Ankara Bilkent City Hospital — Ankara
Publications
- Abd-Elsayed A, Argall TR, Henjum LJ, McKindsey DM, Perkins NA, Fiala KJ. Radiofrequency Ablation and Pulsed Radiofrequency of Suprascapular Nerves for Managing Chronic Shoulder Pain. Brain Sci. 2025 Aug 26;15(9):915. doi: 10.3390/brainsci15090915. PMID 41008275
- Jain E, O'Connor IT, Tram JK, Varlotta CA, Fiala KJ, Asaad FS, Chitneni A, Abd-Elsayed A. Radiofrequency ablation for shoulder pain: an updated systematic review. Ann Palliat Med. 2024 Jul;13(4):963-975. doi: 10.21037/apm-23-529. Epub 2024 Jul 4. PMID 38988077
- Tran J, Peng P, Agur A. Evaluation of suprascapular nerve radiofrequency ablation protocols: 3D cadaveric needle placement study. Reg Anesth Pain Med. 2019 Sep 16:rapm-2019-100739. doi: 10.1136/rapm-2019-100739. Online ahead of print. PMID 31527162
Identifiers
NCT: NCT07502209 · TABED 1-26-2295 · TABED 1-26-2295