A suprascapular nerve block is an injection of local anesthetic, often with a steroid, around the nerve that carries much of the feeling from the shoulder joint. It is used for shoulder pain from frozen shoulder, arthritis or rotator cuff problems when other options have not helped, and to control pain around shoulder surgery. Expect a numb, heavy shoulder for several hours. If a steroid is included, relief often builds over a few days and may last weeks to around three months.
The block does not change the joint itself. It turns down the pain signal for a while, which can make sleep, movement and exercise easier.
Key takeaways
- What it is: local anesthetic, often with a steroid, injected near the suprascapular nerve at the top of the shoulder blade.
- Why it is used: for persistent shoulder pain from frozen shoulder, arthritis or rotator cuff problems, and around shoulder surgery.
- First hours: the shoulder usually feels numb and heavy, and lifting or turning the arm out may be weak until the anesthetic wears off.
- How long it lasts: with a steroid, relief often lasts weeks to around three months, and varies widely.
- Using the window: the weeks of easier pain are the time to build movement and strength.
What the injection is and why it is used
The suprascapular nerve runs across the top of the shoulder blade and supplies a large share of the feeling from the shoulder joint, as well as two rotator cuff muscles. A doctor injects close to it, usually guided by ultrasound. It takes a few minutes and you stay awake.
It is most often considered for frozen shoulder in its painful stage, shoulder arthritis, and rotator cuff tears where surgery is not planned. It is an alternative or addition to a cortisone shot into the shoulder, which treats the joint or bursa directly. For frozen shoulder, it is sometimes used alongside hydrodilatation. Anesthetists also use it around surgery to ease pain in the first day or so.
Day by day: the first week
- Injection day: the shoulder feels numb and heavy for several hours, sometimes up to a day. Use the arm gently, avoid lifting, and do not drive home.
- Days 1 to 3: as the anesthetic wears off, pain can return, sometimes worse than before for a day or two. The injection site may be sore or bruised.
- Days 3 to 7: if a steroid was used, relief usually starts to build. Sleep is often the first thing to improve.
Weeks 2 to 6
Pain is usually at its lowest in this stretch. Most people can return to daily tasks and work. A short flare after a busy day is common and usually settles within a day or two.
How long it lasts and how to use the window
Local anesthetic alone wears off within hours. With a steroid, relief often lasts weeks to around three months, and some people notice little change. The benefit tends to last longer when the easier weeks are used well.
- Movement: regain range the pain was blocking. For frozen shoulder, frozen shoulder exercises by stage show how far to push.
- Strength: build the rotator cuff and shoulder blade muscles gradually over 6 to 12 weeks.
- Sleep: if shoulder pain at night was the main problem, keep the positions that work as the effect fades.
How many injections are usually considered
If the first block helps, it may be repeated when the effect wears off. When a steroid is included, doctors usually limit how many are given in a year, often to around three. If blocks help but keep wearing off, pulsed radiofrequency treatment of the nerve is sometimes offered. If a block gives no relief, repeating it is less likely to help.
A nerve block buys a window of easier movement; what you do in that window carries the benefit forward.
Is this normal?
- The arm felt dead for hours: expected. The nerve also supplies two shoulder muscles, so lifting and turning out can be weak until the anesthetic wears off.
- Pain was worse on day two: common in the gap between the anesthetic wearing off and a steroid starting to work.
- My face felt hot and sleep was poor: flushing and restless sleep for a day or two can follow a steroid.
- It helped, then wore off: this is the usual pattern. Tell your doctor how many weeks you had.
Call your local emergency number or go to the emergency department if
- Breathing: sudden breathlessness or sharp chest pain when breathing in after the injection.
- Allergic reaction: swelling of the face, lips or throat, or trouble breathing.
- Heart signs: chest pain with sweating or pain spreading to the jaw or left arm.
See a doctor today if
- Infection signs: redness, heat or swelling spreading from the injection site.
- Fever: a temperature, chills or feeling unwell after the injection.
- Severe new pain: pain that keeps getting worse after day three.
- Lasting weakness: numbness or weakness in the arm that has not worn off by the next day.
Get it checked soon if
- Blood sugar: you have diabetes and your readings stay above your usual range for more than a few days.
- No change: there is no relief at all after two weeks.
- Quick return: the pain comes back fully within a couple of weeks.
More on this area: injections for neck and shoulder pain.
A suprascapular nerve block eases the pain signal for a while; the movement and strength you build during that time is what lasts.
Written by Louise Yow, Neck & Shoulder Physio.