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to see a list of articles like this one Co-Management of Severe Conditions Prolotherapy as an Adjunct to Chiropractic Care Ultrasound for Evaluation of the Wrist |
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A Letter Released
to Chiropractors on September 11, 2007 The Suprascapular Nerve & Shoulder Pain Lack of bony stability and
superlative capacity for motion make the shoulder one of the body’s most
vulnerable regions for pain, injury, and dysfunction. Everyday, an estimated
15-30% of adults experience shoulder pain.1 The suprascapular nerve conducts
those pain signals in most cases. The
suprascapular nerve originates from the C5 and C6 nerve roots. It provides sensation for about 70% of the
shoulder joint including the superior and posterior regions of the shoulder
joint and capsule and the acromioclavicular joint. A temporary but long lasting suprascapular
nerve block administered by Dr. Taub serves as a meaningful adjunct for many
chiropractic patients. Clearly, a suprascapular nerve
block does not address the original cause of pain. Without restorative
treatment such as manipulation and exercise, patients experience a high rate
of recurrence.2,3 However,
recent research suggests that the analgesic effects of suprascapular nerve
blocks enhances physical therapy programs, and it is likely that chiropractic
patients experience similar gains.4 Di Lorenzo et al treated one group of
shoulder pain patients with standard physical therapy, and they treated
another group with physical therapy plus a suprascapular nerve block. Compared to patients
receiving only physical therapy, the patients also receiving a suprascapular
nerve block reported less pain during therapy, showed higher compliance with physical
therapy, reported better sleep patterns due to less pain, and demonstrated
increased compliance with the rehabilitation program. It stands to reason that the subset of chiropractic patients who do
not experience prompt pain relief from chiropractic treatment, may also, as a
group, show greater compliance with treatments, better home exercise
patterns, better sleep patterns, and better overall adherence to the
chiropractic treatment plan when a
safe, simple suprascapular nerve block is used to provide prompt analgesia. Chiropractic patients sometimes seek
surgery or other medical options without first consulting the primary
chiropractic physician. One way to
avoid this sometimes problematic behavior is by advising patients upfront
that you will refer the patient for medical analgesia when and if the patient
requests such a referral. Dr. Taub performs the
suprascapular nerve block by injecting steroids or a dilute phenol solution
into the nerve. Dr. Taub sometimes
performs a circumflex nerve block in conjunction with the suprascapular nerve
block to improve results. Analgesia
lasts two to three months. The
treatment does not permanently damage the nerve, and the nerve returns to
normal function in time. The pain
relief from the block outlasts the pharmocological effect of the drug.5 This
effect suggests that the nerve block breaks the self-perpetuating pain cycle
and allows for more rapid and more complete recovery from your restorative
treatments. The suprascapular nerve
block is considered very safe and may be preferable
to repeated consumption of NSAIDs. Dr. Taub uses ultrasound
imaging to guide the injections. Using
imaging during shoulder injections has been shown to improve accuracy and
efficacy.6,7 Ultrasound imaging during this process also
allows for possible diagnosis of tears and other problems in the
shoulder. Patients can receive
suprascapular nerve blocks periodically.
This treatment can single-handedly delay or eliminate the need for
shoulder surgery. In conjunction with
effective chiropractic treatment, results can be very good. Please refer to Neal S. Taub, MD, Physiatrist for co-management of chiropractic
patients. . |
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Home Stroke Rehabilitation About Neal Taub, MD What is a Physiatrist |
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