What is shoulder joint denervation?

Radiofrequency Denervation (also known as Radiofrequency Ablation) is a minimally invasive procedure used to relieve chronic shoulder pain by interrupting the pain signals carried by small sensory nerves around the shoulder joint.

It involves applying heat generated by radiofrequency energy to these nerves, effectively reducing the sensation of pain without affecting movement or joint structure.

What conditions do we offer this for?

This procedure may be offered to carefully selected patients with:
  • Well-localised chronic shoulder pain that has not responded to appropriate conservative treatments, including physiotherapy, medication, or injections.
  • Pain that significantly affects quality of life, sleep, mobility, or day-to-day activities.
  • Shoulder pain due to osteoarthritis, chronic rotator cuff disease, or persistent pain following shoulder surgery.
  • A positive response to a diagnostic shoulder nerve block, indicating that the pain is likely to arise from the targeted sensory nerves.
  • Patients who are not suitable candidates for surgery, wish to delay surgery, or prefer a minimally invasive treatment option

Why is it done?

  Denervation of the knee is performed to:

  • Provide longer-term pain relief (often lasting 6–12 months or longer)
  • Reduce the need for pain medications, especially opioids or anti-inflammatory drugs
  • Improve mobility, walking ability, and quality of life
  • Support physical rehabilitation or delay the need for further surgical intervention

It is typically considered when patients do not have widespread pain and pain relief has been achieved with a diagnostic nerve block but is not sustained.

What does the procedure involve?

  • You will usually lie on your back or side, with the affected shoulder comfortably supported.
  • The skin is cleaned with antiseptic solution, and a local anaesthetic is used to numb the skin.
  • Using ultrasound, fine needles are carefully positioned next to the sensory nerves supplying the shoulder joint.
  • A small electrical current is applied to confirm accurate needle placement. You may notice a brief tingling, tapping, or mild muscle twitch.
  • Once the correct position has been confirmed, local anaesthetic is administered before radiofrequency energy is applied to treat the targeted nerves.
  • Depending on the technique used, either continuous radiofrequency denervation or pulsed radiofrequency may be performed.
  • The procedure usually takes 30–60 minutes and is performed as a day-case procedure, allowing you to return home the same day

Benefits

  • Targeted, long-lasting relief from chronic knee pain
  • Reduced need for daily pain medications
  • Better ability to walk, exercise, and sleep
  • May delay or reduce the need for further surgery
  • Does not affect muscle control or joint movement

Side Effects

Very Common side effects

(may affect more than 1in 10 patients):
  • Pain or bruising at the needle site
  • Temporary increase in shoulder pain
  • Mild numbness around the front or sides of the shoulder 

Common side effects

(may affect up to 1in 10 patients):
  • Localised swelling or discomfort
  • Change in sensation around the shoulder and upper arm

 Uncommon side effects

(may affect up to 1 in 1,00 patients):
  • Skin burn or superficial infection
  • Temporary arm weakness 
  • Lung injury (pneumothorax)

 Rare side effects

(may affect up to 1 in 1,000 patients):
  • Nerve injury or prolonged numbness
  • Bleeding or haematoma
  • Allergic reaction to local anaesthetic

Aftercare Advice

  • You will be monitored after the injection and usually discharged the same day.
  • Avoid driving for 24 hours.

  • Some discomfort or swelling around the shoulder may last a few days — use ice packs and simple painkillers as advised.

  • Gradually resume activities; but avoid high-impact exercise initially.

  • Physiotherapy or a home exercise programme may be recommended for long-term benefit.

When to Seek Medical Attention

Please attend A&E immediately if you experience:

  • Fever, chills, or signs of infection at the injection site
  • Sudden chest pain, breathlessness, or dry cough
  • New or worsening arm numbness or weakness