Does a Suprascapular Nerve block reduce chronic shoulder pain at 3 months compared to standard non-operative care? A systematic review

Purpose: Chronic shoulder pain affects 2.4–30% of adults at any given time because of a wide variety of underlying pathologies. Treatment of chronic shoulder pain should attempt to address the underlying cause, if possible, either through surgical or non-surgical means. Routine non-operative care involves analgesia, physiotherapy and perhaps injection of corticosteroid at the appropriate site. A suprascapular nerve block (SSNB) is a minimally invasive, low-risk procedure which offers analgesia for patients. This review evaluates the effectiveness of SSNB in reducing shoulder pain at a 3-month follow-up, in comparison to standard non-operative care. Methods: A literature search was conducted across Medline, Embase, Cochrane, ISRCTN and clinicaltrial.gov databases from inception to November 2024. Ninety publications were screened by abstract followed by full text, by the authors against inclusion criteria, and risk of bias was assessed using the RoB 2 tool. Results: Five randomised studies were included for analysis, presenting a heterogeneous mix of intervention, study populations and outcome measures. The two studies performing SSNB with local anaesthetic (LA) and corticosteroid found a significant reduction in pain at 3 months. In contrast, compared to studies using LA alone did not demonstrate the same level of efficacy. Conclusion: Suprascapular nerve block is an effective analgesic option for chronic shoulder pain, which can be offered to patients as part of a shared decision-making approach. While studies suggest efficacy of combined LA and corticosteroid, limitations such as heterogeneity, variability in result reporting and short follow-up periods reduce the strength of the evidence.