A UK-based consensus exercise to determine the most acceptable method of suprascapular nerve block injection for people consulting with rotator cuff disorders

Neil Smith; Dr Caroline Miller; Dr Steve Gwilym; Emma L Healey

doi:10.1177/17585732251350116

A UK-based consensus exercise to determine the most acceptable method of suprascapular nerve block injection for people consulting with rotator cuff disorders

Shoulder Elbow. 2025 Jun 24:17585732251350116. doi: 10.1177/17585732251350116. Online ahead of print.

Authors

Neil Smith¹, Dr Caroline Miller², Dr Steve Gwilym³, Emma L Healey⁴

Affiliations

¹ Sandwell and West Birmingham NHS Trust, Sandwell Hospital, West Bromwich, West Midlands, UK.
² Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham Foundation Trust, Birmingham, UK.
³ Oxford Clinical Trials Research Unit, Oxford Trauma, Kadoorie Centre, NDORMS, University of Oxford, Oxford, UK.
⁴ Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, UK.

Abstract

Introduction: Suprascapular nerve block (SSNB) injections are used to treat shoulder pain in clinical practice. Its effectiveness compared to other shoulder pain relieving injections requires evaluation in high quality clinical trials. A range of different methods are used for SSNB injections. This study aimed to gain expert consensus on the most acceptable method of delivering SSNB injection in a future comparative clinical trial.

Methods: Between October 2023 and May 2024, we conducted a three stage, online, modified Delphi survey with NHS clinicians who currently perform SSNB injections in the United Kingdom.

Results: Thirty-eight NHS registered healthcare professionals completed Stage 1, 34 completed Stage 2 and 25 completed Stage 3. Anatomical land-marked and ultrasound guided SSNB injection methods reached consensus as acceptable to use in a multi-centre clinical trial. Targeting the supraspinatus fossa (SSF) or the suprascapular notch (SSN) reached consensus as acceptable. Finally, Kenalog (40 mg) or Depo-medrone (40 mg) combined with either Bupivacaine 0.25% (5-10 ml), Bupivacaine 0.5% (5 ml to10 ml), Lidocaine 1% (5-10 ml) all reached consensus as acceptable injectates.

Conclusions: This consensus study has provided valuable information from expert NHS clinicians to help determine the method of SSNB injection delivery in the conduct of a future clinical trial.

Keywords: Delphi; consensus; suprascapular nerve block.