Disclosures: Brian M. Dena, DO: Nothing to disclose

Case Description: The patient presented with chronic right shoulder pain that was limiting daily activities, interfering with sleep, and requiring increased assistance with ADLs. Physical exam of right arm revealed decreased active and passive range of motion and strength limited by severe pain. MRI and ultrasound of the right shoulder demonstrated severe osteoarthritis of glenohumoral joint with large loose bodies, severe osteoarthritis of acromioclavicular joint, and tendinopathy of the rotator cuff muscles. Orthopedic intervention was deferred secondary to recently diagnosed movement disorder. Corticosteroid joint injection was unsuccessful. He subsequently underwent diagnostic suprascapular nerve block twice (with lidocaine and subsequently with xeomin), which failed to provide lasting relief. The decision was made to proceed with peripheral nerve stimulator via suprascapular nerve approach.

Setting: Outpatient Pain Medicine Clinic

Patient: A 70-year-old man with newly diagnosed Parkinson’s disease and chronic right shoulder pain.

Assessment/Results: At initial follow up via phone call, the patient reported 100% improvement in pain. At 3 weeks post implantation he reported pain relief and improved sleep. Caregiver reported improvement in independence with ADLs (self-feeding, steering wheel, light object lifting). A SPADI (Shoulder pain and disability index) done at initial follow up was 61.5.

Discussion: This is the first reported case, to our knowledge, of peripheral nerve stimulator placement via suprascapular nerve approach in the rehabilitation literature for the purpose of reducing chronic nociceptive shoulder pain.

Conclusion: This case demonstrates promising results for the use of suprascapular nerve approach for placement of peripheral nerve stimulator in the treatment of chronic nociceptive shoulder pain for patients without surgical options.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/peripheral-nerve-stimulator-for-the-treatment-of-chronic-nociceptive-shoulder-pain-via-suprascapular-approach-a-case-report/