Shoulder pain can arise from a compression of the suprascapular nerve in the superior scapular notch. The nerve passes under the transverse scapular ligament at the top of the shoulderblade or scapula. This creates a tight spot or a kink point in the nerve leading to pain, usually in the back of the shoulder. Patients describe the pain as a gnawing sensation which is made worse with certain positions of the scapula. Some patients also experience numbness or burning in the back of the shoulder.
The diagnosis of suprascapular nerve compression is established by placing an ultrasound guided injection of numbing medicine in the suprascapular notch, next to the nerve. If this injection results in immediate relief of the pain, the diagnosis is confirmed. Although the pain relief from this injection is short lasting, the injection helps us to know the source of the pain. Permanent relief can often be achieved by a minimally invasive procedure to release the nerve.