Pain Management Procedures
Suprascapular and Axillary Nerve Blocks
Suprascapular and Axillary Nerve Blocks
What are these shoulder nerve blocks?
The suprascapular and axillary nerves carry much of the pain sensation from the shoulder joint. Blocking one or both can reduce shoulder pain without injecting directly into the joint. These blocks may also help determine which structures are contributing to pain.
When may they be recommended?
They may be considered for chronic shoulder pain related to osteoarthritis, adhesive capsulitis, rotator-cuff disease, postsurgical pain, or pain after injury. A suprascapular block often targets pain toward the back or top of the shoulder; the axillary nerve contributes sensation to the front and side of the shoulder. Because other nerves also supply the joint, one block may not cover every painful area.
What happens?
The clinician uses ultrasound to identify the nerve and nearby blood vessels. After the skin is cleaned and numbed, a small needle is guided beside the nerve and local anesthetic, sometimes with steroid, is injected. The arm may feel temporarily numb, heavy, or weak.
What should I expect afterward?
Protect the numb arm until strength and sensation return. Do not drive or use machinery if the arm is weak. Relief from local anesthetic begins quickly; any longer anti-inflammatory effect takes more time. If a temporary block works well but relief fades, another treatment such as RFA or peripheral nerve stimulation may be discussed in selected cases.
Important risks
Risks include bleeding, infection, medication reaction, nerve irritation or injury, temporary weakness, and local-anesthetic toxicity if medicine enters the bloodstream. A posterior suprascapular approach is often chosen to reduce effects on breathing, but the safest technique depends on the patient and target.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.