Ultrasound-Guided High-Voltage Long-Duration Pulsed Radiofrequency of the Suprascapular Nerve for Persistent Hemiplegic Shoulder Pain.
Lulu Pan, Yingjie Shi, Sujin Lin et al.
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Case in brief
The report describes two patients with persistent hemiplegic shoulder pain after stroke, in whom conventional conservative care or suprascapular nerve blocks may provide inadequate relief. Both underwent ultrasound-guided high-voltage long-duration pulsed radiofrequency (HL-PRF) targeting the suprascapular nerve. At one-month follow-up, both had lower resting and movement-evoked pain scores and greater passive shoulder range of motion. At three-month telephone follow-up, pain scores remained below baseline. No procedure-related adverse events were observed or documented during the available follow-up. These illustrative cases do not establish treatment efficacy.
What made this case unusual
The report presents an ultrasound-guided HL-PRF protocol using 99 V for 6 min, with temperature maintained at or below 42 °C, for persistent post-stroke shoulder pain.
Diagnostic / clinical pearl
Ultrasound can guide suprascapular nerve targeting and visualization of adjacent vessels; sensory and motor stimulation are used to confirm cannula position before HL-PRF delivery.
Why it matters
The procedural description offers a framework for applying this technique, while the uncontrolled observations should be interpreted as illustrative rather than evidence of efficacy.