**Integral Management in Painful Shoulder Treatment: Anesthesiologist's Point of View Anesthesiologist's Point of View**

**Integral Management in Painful Shoulder Treatment:** 

DOI: 10.5772/intechopen.69914

José Miguel Esparza Miñana José Miguel Esparza Miñana Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.69914

#### **Abstract**

Shoulder pain is a common complaint in clinical practice. The usual form of treatment is based on nonsteroidal anti-inflammatory drugs (NSAIDs), rest, rehabilitation and, as an alternative, a local injection into the joint. Due to the lack of oral medication and the lack of evidence, it is necessary to use different nonsurgical therapeutic alternatives. Pulsed radiofrequency produces a temporary nondestructive blockage being the most common technique in the management of shoulder pain. The application of pulsed radiofrequency on the suprascapular nerve has proven to be an effective method in the treatment of shoulder pain, with a decrease in pain that allows the rehabilitation of patients. The axillary or circumflex nerve provides motor innervation mainly to deltoids with branches to the teres minor, provides sensitive innervation to the lower, lateral, and anterior articular capsule, and innervates the humeral head and upper humeral neck. It has a cutaneous branch, which contributes sensitivity of the skin on the deltoids. Combined pulsed radiofrequency on the suprascapular nerve and on the circumflex nerve has been scarcely studied with very few references in the literature. The joint treatment by pulsed radiofrequency technique on suprascapular nerve and circumflex nerve can provide a complete and lasting relief of this pathology.

**Keywords:** shoulder, suprascapular nerve, circumflex nerve, radiofrequency, chronic pain
