• D Jankovic and A van Zundert.
• Pain Management Centre, Cologne-Huerth, Germany. danilo@jankovic1.de
• Acta Anaesthesiol Belg. 2006 Jan 1;57(2):137-43.

Background And ObjectivesA frozen shoulder is considered by some authors to be a common stage of many disorders affecting the shoulder, while others regard it as an independent idiopatic condition. A consistent finding is that subscapularis muscle trigger points play a key role in the development of the frozen shoulder syndrome. Apart from the conventional treatment, a selective subscapularis fossa nerve block combined with subscapularis trigger points infiltration, may be an effective treatment in preventing chronic pain.MethodsIn this manuscript the posterior injection technique of the subscapularis fossa nerve block is described.ResultsFive patients with typical symptoms of frozen shoulder, who did not respond to conventional treatment, but obtained pain relief after a combination of a subscapularis nerve block with the infiltration of trigger points, are presented.ConclusionThe results of this block in various painful situations of the shoulder region suggest the importance of subscapularis muscle in the etiology of the frozen shoulder. Using this technique, we could demonstrate that a subscapular nerve block and subscapularis trigger points infiltration have both a diagnostic and therapeutic value for the treatment of the frozen shoulder.

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