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Shoulder Denervation , RF ablation, the evidence , Anatomy, Procedure all articles available

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shoulder radiofrequency ablation

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shoulder joint radiofrequency ablation denervation systematic review guideline anatomy procedure

This is a large review topic, and “all articles” needs a defined scope to make the bibliography useful rather than indiscriminate. The main areas are:
  1. Indications and patient selection - glenohumeral osteoarthritis, rotator cuff disease, adhesive capsulitis, post-arthroplasty or cancer-related pain.
  2. Anatomy and targets - suprascapular, axillary, lateral pectoral, and variable subscapular articular branches.
  3. Techniques - diagnostic blocks; conventional thermal, pulsed, and cooled RF; ultrasound, fluoroscopy, and CT guidance.
  4. Clinical evidence - systematic reviews, RCTs, cohorts, outcomes, duration of benefit, and complications.
  5. Procedure guide - a clinician-facing, image-guided workflow with safety considerations.
  6. Literature bibliography - a structured list of key anatomy, technique, and outcome papers with PMIDs/DOIs.
The evidence base is promising but still limited by small heterogeneous studies and varying targets/lesion methods. A 2024 systematic review (PMID 38988077) and a newer 2026 systematic review (PMID 42699101) are important anchors.
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Which deliverable should I prepare first? · Which shoulder-pain population should be prioritized?

This is a large review topic, and “all articles” needs a defined scope to make the bibliography useful rather than indiscriminate. The main areas are:
  1. Indications and patient selection - glenohumeral osteoarthritis, rotator cuff disease, adhesive capsulitis, post-arthroplasty or cancer-related pain.
  2. Anatomy and targets - suprascapular, axillary, lateral pectoral, and variable subscapular articular branches.
  3. Techniques - diagnostic blocks; conventional thermal, pulsed, and cooled RF; ultrasound, fluoroscopy, and CT guidance.
  4. Clinical evidence - systematic reviews, RCTs, cohorts, outcomes, duration of benefit, and complications.
  5. Procedure guide - a clinician-facing, image-guided workflow with safety considerations.
  6. Literature bibliography - a structured list of key anatomy, technique, and outcome papers with PMIDs/DOIs.
The evidence base is promising but still limited by small heterogeneous studies and varying targets/lesion methods. A 2024 systematic review (PMID 38988077) and a newer 2026 systematic review (PMID 42699101) are important anchors.

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shoulder radiofrequency ablation

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shoulder pain radiofrequency systematic review

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shoulder joint innervation anatomy articular branches

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site:pubmed.ncbi.nlm.nih.gov shoulder radiofrequency ablation suprascapular axillary lateral pectoral

Key articles: shoulder denervation and radiofrequency ablation

Systematic reviews and evidence synthesis

  1. Jain E, O'Connor IT, Tram JK, et al. Radiofrequency ablation for shoulder pain: an updated systematic review. Annals of Palliative Medicine. 2024. doi:10.21037/apm-23-529. PubMed PMID 38988077
  2. Moria HA, et al. Pulsed and cooled radiofrequency for chronic shoulder pain: a systematic review of comparative and cohort studies. Frontiers in Medicine. 2026. doi:10.3389/fmed.2026.1747949. PubMed PMID 42699101
  3. Pushparaj H, Hoydonckx Y, Mittal N, et al. A systematic review and meta-analysis of radiofrequency procedures on innervation to the shoulder joint for relieving chronic pain. European Journal of Pain. 2021;25:986-1011. doi:10.1002/ejp.1735. PubMed PMID 33471393
  4. Sebastián Infante J, Blackburn N, Felipe Vargas J, et al. Radiofrequency of suprascapular nerve as an analgesic strategy for chronic pain management: systematic review and meta-analysis. Revista Española de Anestesiología y Reanimación. 2024. doi:10.1016/j.redare.2024.07.006. PubMed PMID 38987019
  5. Orhurhu V, Akinola O, Grandhi R, et al. Radiofrequency ablation for management of shoulder pain. Current Pain and Headache Reports. 2019;23:56. doi:10.1007/s11916-019-0791-z. PubMed PMID 31292738
  6. Liu A, Zhang W, Sun M, et al. Evidence-based status of pulsed radiofrequency treatment for patients with shoulder pain: a systematic review of randomized controlled trials. Pain Practice. 2016;16:518-525. doi:10.1111/papr.12310. PubMed PMID 25990576

Anatomy and target nerves

These papers support the present multi-target concept: sensory articular input commonly involves suprascapular, axillary, lateral pectoral, and, variably, subscapular branches. Targets differ according to whether the pain generator is glenohumeral, acromioclavicular, rotator-cuff related, or diffuse.
  1. Eckmann MS, Bickelhaupt B, Fehl J, et al. Cadaveric study of the articular branches of the shoulder joint. Regional Anesthesia and Pain Medicine. 2017;42:564-570. doi:10.1097/AAP.0000000000000652. PubMed PMID 28786899
  2. Tran J, Switzer-McIntyre S, Agur AMR. Overview of innervation of shoulder and acromioclavicular joints. Physical Medicine and Rehabilitation Clinics of North America. 2021;32:667-674. doi:10.1016/j.pmr.2021.05.005. PubMed PMID 34593135
  3. Laumonerie P, Dalmas Y, Tibbo ME, et al. Sensory innervation of the human shoulder joint: the three bridges to break. Journal of Shoulder and Elbow Surgery. 2020. doi:10.1016/j.jse.2020.07.017. PubMed PMID 32712453
  4. Martínez-Gago A, García-Mesa Y, Cuendias P, et al. Sensory innervation of the human shoulder joints in healthy and in chronic pain shoulder syndromes. Annals of Anatomy. 2024;252:152206. doi:10.1016/j.aanat.2023.152206. PubMed PMID 38154784
  5. Nam YS, Panchal K, Kim IB, et al. Anatomical study of the articular branch of the lateral pectoral nerve to the shoulder joint. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24:3820-3827. doi:10.1007/s00167-015-3703-8. PubMed PMID 26194117
  6. Aszmann OC, Dellon AL, Birely BT, McFarland EG. Innervation of the human shoulder joint and its implications for surgery. Clinical Orthopaedics and Related Research. 1996;330:202-207. PubMed PMID 8804294

Procedure and technique articles

  1. Samaan A, Spinner D. Shoulder ablation approaches. Physical Medicine and Rehabilitation Clinics of North America. 2021;32:675-690. doi:10.1016/j.pmr.2021.07.002. PubMed PMID 34593136
  2. Kallas ON, Nezami N, Singer AD, et al. Cooled radiofrequency ablation for chronic joint pain secondary to hip and shoulder osteoarthritis. RadioGraphics. 2022;42:594-608. doi:10.1148/rg.210074. PubMed PMID 35148246
  3. Burnham TR, Miller S, Cooper AN, et al. Shoulder terminal sensory articular nerve radiofrequency ablation for nonsurgical refractory shoulder pain due to rotator cuff pathology and osteoarthritis: a technical note. Pain Medicine. 2024. doi:10.1093/pm/pnae035. PubMed PMID 38688587
  4. Eckmann MS, et al. Thermal radiofrequency ablation of the articular branch of the lateral pectoral nerve for shoulder pain: a case series and novel technique. Pain Medicine. 2019. PubMed PMID 31567126
  5. Tran J, et al. Diagnostic block and radiofrequency ablation of the acromial branches of the lateral pectoral and suprascapular nerves. Pain Medicine. 2021. PubMed PMID 33574156
  6. Stogicza AR, et al. A motor-sparing approach to rotator cuff disease. Regional Anesthesia and Pain Medicine. 2022. PubMed PMID 35701009

Clinical outcome studies, especially cooled RF

  1. Tran A, Reiter DA, Fritz J, et al. Pilot study for treatment of symptomatic shoulder arthritis utilizing cooled radiofrequency ablation: a novel technique. Skeletal Radiology. 2022;51:609-617. doi:10.1007/s00256-022-03993-y. PubMed PMID 35029737
  2. Yoshida M, Park PK, Thang LV, et al. Evaluation of internally cooled radiofrequency ablation targeting multiple shoulder nerves for chronic shoulder pain relief and function restoration: a prospective study. Pain Medicine. 2025. doi:10.1093/pm/pnaf016. PubMed PMID 40036562
  3. Nava-Obregon T, Palacio-Ríos D, López-Ríos F, et al. Cooled radiofrequency ablation in shoulder pain: a cohort study. Cureus. 2025;17:e79922. doi:10.7759/cureus.79922. PubMed PMID 40171363
  4. Abd-Elsayed A, Argall TR, Henjum LJ, et al. Radiofrequency ablation and pulsed radiofrequency of suprascapular nerves for managing chronic shoulder pain. Brain Sciences. 2025;15:915. doi:10.3390/brainsci15090915. PubMed PMID 41008275
  5. Liliang PC, Lu K, Hsieh CH, et al. Pulsed radiofrequency lesioning of the suprascapular nerve for chronic shoulder pain. Pain Medicine. 2009. PubMed PMID 19222771

Practical reading order

For an evidence review or presentation, start with:
  1. Jain 2024 and Moria 2026 for the current evidence summary.
  2. Pushparaj 2021 for the earlier meta-analysis.
  3. Eckmann 2017, Tran 2021, and Laumonerie 2020 for target anatomy.
  4. Kallas 2022, Samaan 2021, and Burnham 2024 for procedural planning.
  5. Tran 2022 and Yoshida 2025 for cooled-RF clinical outcomes.
Evidence interpretation: shoulder RF denervation appears to reduce pain and may improve function in selected refractory chronic shoulder-pain patients, particularly osteoarthritis and rotator-cuff pathology. However, the literature remains heterogeneous: targets, diagnostic-block criteria, RF modality, imaging guidance, and follow-up differ substantially. Evidence is stronger for short-to-intermediate pain relief than for durable long-term benefit or a single standardized technique.
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