Suprascapular Nerve Release
Shoulder Surgery
Suprascapular nerve release may be used to relieve shoulder pain. Dr James McLean performs this procedure with an arthroscopic approach, minimising damage to the surrounding tissue.
What is suprascapular nerve release?
Suprascapular nerve release is a surgical procedure performed to relieve suprascapular nerve entrapment. It works by removing the pressure on the nerve, reducing or eliminating pain and discomfort.
What is suprascapular nerve entrapment?
The suprascapular nerve is a major nerve which runs from the brachial plexus into the shoulder. It may be impinged (trapped) by cysts, tumours, or structural changes to the scapular bone, resulting in irritation. It tends to feel like a severe, deep aching pain which comes from the top of the shoulder and may radiate into the back, neck, and arm.
It is most often seen in people who make repetitive overhead motions, such as athletes and tradies. While the condition is considered rare, its clinical frequency is gradually increasing.
When is suprascapular nerve release performed?
Suprascapular nerve release is performed to relieve pressure on a trapped suprascapular nerve. This may be indicated by pain and weakness throughout the shoulder, neck, arm, and upper back which has not improved with conservative management techniques.
There are several points at which the suprascapular nerve can be impinged, the most common being the at the suprascapular notch (at the top of the scapula). Before undergoing arthroscopic suprascapular nerve release, you may be referred for further imaging to confirm the location and exact diagnosis.
What does the arthroscopic suprascapular nerve release procedure involve?
Arthroscopic suprascapular nerve release is performed under a local anaesthetic.
A small incision is made in the top of the shoulder, and a tiny camera (arthroscope) is inserted to allow for viewing of the area. Dr James McLean uses this to confirm the suprascapular impingement and the surgical approach needed to rectify it.
Other small incisions are then made in the front of the shoulder, allowing access for the small tools used. These are used to move or remove remove cysts, tumours, damaged tissue, bone spurs, or other structures causing impingement.
After the procedure, the tools are retracted and the wounds are closed with sutures or surgical tape.
What risks are involved?
Like any surgical procedure, arthroscopic suprascapular nerve release carries certain risks. Although the arthroscopic approach can reduce some by minimising disruption to the surrounding tissue, other are still applicable. These may include:
- Damage to the suprascapular nerve
- Damage to the surrounding tissues of the shoulder
- Blood clots
- Reactions to anaesthesia
- Infection of the wound site post-procedure
- Ongoing pain and/or weakness
- Failure to heal completely
Complications in the healing process can lead to severe outcomes. If you notice any concerning symptoms after your procedure, it’s important to discuss them with your orthopaedic surgeon as soon as possible.
Recovery following arthroscopic suprascapular nerve release
Immediately after the surgery, your arm will be placed in a sling for your own comfort.
However, you will be allowed to gently move your arm as soon after surgery as pain permits. You will be prescribed medication to help relieve pain, and may be advised to sleep with a pillow under the affected shoulder.
A follow-up appointment with Dr James McLean will be scheduled about 3 weeks after your procedure. This appointment will include a physical examination to check your healing progress, assessment for signs of complication, and advice on returning to work and normal activities.
Your surgeon will develop an exercise rehabilitation program to help improve your shoulder strength and range of motion. Generally speaking, you can resume light activities within 6 weeks of the procedure.
Shoulder Conditions
Browse the links below for more information on specific shoulder conditions, including the main causes, symptoms and treatments.
Shoulder Arthritis
Shoulder arthritis can cause deep joint pain, stiffness, grinding and reduced movement. It may affect the main ball and socket joint or the smaller AC joint at the top of the shoulder. Treatment could include physiotherapy, medication, injections and surgery.
Shoulder Instability
A shoulder that repeatedly slips, gives way or dislocates may have chronic instability. This can develop after a previous dislocation or from loose supporting tissues. Treatment may include rehabilitation or surgery based on the injury and level of instability.
Shoulder Fractures
A shoulder fracture can involve the upper arm bone, collarbone or shoulder blade. Falls, sports injuries, cycling accidents and direct impacts are common causes. Some fractures heal with a sling and rehabilitation, though displaced or unstable fractures may require surgery.
Frozen Shoulder
Frozen shoulder causes progressive pain and stiffness as the capsule around the shoulder joint tightens. Daily tasks such as dressing, washing your hair or reaching behind your back become difficult. Treatment may include physiotherapy, injections or hydrodilatation, and surgery.
Shoulder Replacement
Shoulder replacement is considered for severe arthritis, some complex fractures or shoulder damage linked with a poorly functioning rotator cuff. Different forms of replacement are used for different shoulder problems, including anatomic and reverse shoulder replacement.
Shoulder Dislocation
A shoulder dislocation happens when the upper arm bone moves out of the socket, usually during sport, a fall or other traumatic injury. After the shoulder is relocated, further review may be needed to assess ligament, labral or bone damage and the risk of another dislocation.
Rotator Cuff Injuries
The rotator cuff is a group of muscles and tendons that helps lift and rotate the arm. Problems can include tendinitis, bursitis and partial or full-thickness tendon tears. Common signs include pain when raising the arm, weakness, difficulty reaching behind your back and pain when lying on the affected shoulder.
Bursitis and Impingement
Bursitis and impingement can cause pain around the front or side of the shoulder, especially when lifting the arm overhead or sleeping on the affected side. Non-surgical treatments are guided, though shoulder arthroscopy may be discussed for cases where symptoms continue.
Shoulder Treatments and Surgery
Surgical Shoulder Procedures and Treatments
Surgery may be discussed if symptoms remain limiting, there is significant damage or an injury needs repair. Procedures performed for shoulder conditions can include:
- Arthroscopic keyhole surgery
- Arthroscopic debridement
- Subacromial decompression (acromioplasty)
- Rotator cuff repair
- Labral or Bankart repair
- Biceps tenodesis or tenotomy
- AC joint excision
- Capsular release
- Tendon transfer
- Shoulder stabilisation surgery
- Fracture fixation
- Shoulder replacement
If Dr James McLean recommends a procedure, this will be based on the condition, examination and imaging findings and explained clearly before any decisions need to be made.
Non-Surgical Shoulder Treatments
Many shoulder conditions do not need surgery. Non-surgical treatment may include:
- Activity changes
- Physiotherapy and rehabilitation
- Medication where suitable
- Corticosteroid injections
- Hydrodilatation for frozen shoulder
- Manipulation under anaesthesia (MUA) for frozen shoulder
- Monitoring and repeat imaging
Common Shoulder Injuries
Browse the links below for more information on common shoulder injuries, including the main causes, symptoms and treatments.
Biceps Tenotomy
A procedure to relieve pain by releasing the long head of the biceps tendon from its attachment to the shoulder.
Suprascapular Nerve Release
Surgical relief of nerve compression in the shoulder to alleviate pain and restore function.
Labral (Bankart) Repair for Instability
Reconstructive surgery to address shoulder dislocation by repairing the torn labrum.
Subacromial Decompression
A minimally invasive surgery to increase space in the shoulder joint, easing movement and reducing pain.
Post-Operative Shoulder Exercises
Tailored rehabilitation activities designed to strengthen the shoulder and improve the range of motion after surgery.
Biceps Tenodesis
Surgically anchoring the biceps tendon to a stable location to alleviate symptoms associated with tendon tears or inflammation.
Latarjet Procedure for Instability
A surgical technique that transfers a piece of bone to the shoulder socket, providing stability and preventing dislocation.
Shoulder Arthroscopy – Acromioclavicular Joint Excision
Key-hole surgery to remove a small piece of the clavicle, relieving pain from arthritis or impingement.
Shoulder Arthroscopy – Animation
Visualisation technique using animation to demonstrate how arthroscopic shoulder surgery is performed.
Shoulder Arthroscopy – SLAP Repair
Repair of a SLAP lesion, which is a tear of the rim of the shoulder socket where the biceps tendon attaches.
Tendon Transfer for Massive Rotator Cuff Tears
Reconstructive surgery where a tendon is transferred to compensate for irreparable rotator cuff damage.
Scapulothoracic Arthroscopy
Depending on the type and severity of your shoulder injury, surgery might be the best option. Dr James McLean specialises in minimally invasive arthroscopic (key-hole) surgery. His aim is to get you the best possible outcome, taking into account your lifestyle, general health and family situation. Before surgery, Dr McLean will guide you through the process and address any concerns you have.
If you have a sports injury or other shoulder condition, it is best to act quickly. Delaying treatment can cause permanent damage and reduce the potential for a full recovery.
Call our friendly team on 08 7077 0101 to make an appointment or use our handy online booking service. Consultations are available in Dulwich (SA), Bedford Park (SA) and Elizabeth Vale (SA).
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