Patient with Severe Shoulder Pain

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Presenting Complaint

80 year old patient presented with severe pain in the left shoulder of at least 3 years duration. She described the pain as an aching pain, exacerbated significantly with any activities, including house hold chores and personal care. Pain was also exacerbated by lying on her side and sleep was constantly disturbed.

Previous Investigations/ Treatments

Over the years she had input from various specialists including the physiotherapists, osteopaths, chiropractors and the orthopaedic team. She has had various tests including ultrasound scan and MRI scans which revealed a rotator cuff tear. She was recommended conservative treatment and physiotherapy, which unfortunately made her pain worse. She tried various medications including Paracetamol, Codeine,Gabapentin, Pregabalin, Amitriptyline and Morphine, but could not tolerate the side effects. She has a shoulder injection through the orthopaedic team but this did not give her any pain relief.

Treatment from Dr. Krishna at Pain Spa

The patient saw Dr. Krishna in his clinic at the Willow surgery in Bristol, desperate for some pain relief. Dr. Krishna recommended a Supra scapular nerve block under ultrasound guidance as a diagnostic procedure, followed by Supra scapular nerve pulsed radiofrequency ablation for sustained pain relief. This treatment was also performed under ultrasound  guidance without any problems.


The patient had excellent pain relief from both treatments. A further review was conducted at 3 months and 6 months post procedure, when she reported significant improvement in her shoulder pain. In fact, she had been almost completely pain free following the nerve ablation treatment and was focussing on the exercises given by the physiotherapist. Her function also improved significantly and she was now able to do her activities around her house without much pain.

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