Subthreshold Peripheral Nerve Stimulation with a High Frequency Electro-Magnetic Couple Powered Implanted Receiver for the Treatment of Chronic Shoulder Pain

BACKGROUND: Shoulder pain has an estimated population prevalence of up to 26%. The most common source of shoulder pain is the rotator cuff, which is a group of muscles and tendons that surround the shoulder joint, accounting for over two-thirds of cases. CASE REPORT: A 65-year-old man presented with sharp, localized pain on abduction of the left shoulder due to a left rotator cuff tear. A diagnostic nerve block provided 100% short-term pain relief. Subsequently a peripheral nerve stimulator trial was offered to the patient, which was successful. The permanent peripheral nerve stimulator was implanted at the supraspinous fossa with the middle electrodes at the suprascapular notch. A receiver was inserted into the inner lumen of electrode array and the neurostimulator was coiled and fixated to the fascia. The following stimulation settings were used: frequency at 1.5 kHz, pulse width at 30 µs, and amplitude of 3.5 mA. CONCLUSION: At one year after implant, the patient had close to 100% pain relief and reported excellent mobility of the shoulder. Wirelessly powered peripheral nerve simulation was a successful option for this patient suffering from debilitating left shoulder pain due to a left rotator cuff tear. KEY WORDS: Chronic shoulder pain, glenohumeral osteoarthritis, peripheral nerve stimulator, suprascapular neuralgia