Suprascapular Nerve Block: Targeted Relief for Chronic Shoulder Pain

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A suprascapular nerve block is an image-guided injection placed near the suprascapular nerve, one of the most important sensory nerves involved in shoulder pain. This nerve helps carry pain signals from major parts of the shoulder joint, including the glenohumeral joint and acromioclavicular joint.

At SpinePain Solutions, suprascapular nerve block is a valuable tool in the treatment of chronic shoulder pain. We use it frequently as a standalone treatment for patients with shoulder arthritis, rotator cuff disease, frozen shoulder, post-surgical shoulder pain, post-replacement pain, or patients who are poor surgical candidates.

It may also be used as part of a broader shoulder articular branch block or shoulder radiofrequency ablation strategy. In those cases, the block is not only a treatment. It may also help confirm whether the sensory nerve pathways around the shoulder joint are important drivers of pain.

A suprascapular nerve block may be diagnostic, therapeutic, or both. If numbing the nerve temporarily relieves the familiar shoulder pain, the block may help confirm that this nerve pathway is involved. If medication around the nerve reduces irritation or inflammation, relief may last longer than the numbing medicine itself.

Quick Answer: What Is a Suprascapular Nerve Block?

It is an injection near a major shoulder sensory nerve. The suprascapular nerve helps carry pain signals from the shoulder joint.
It may help chronic shoulder pain. This includes arthritis, rotator cuff disease, frozen shoulder, post-surgical pain, and post-replacement pain.
It can be useful in poor surgical candidates. Some patients are not ready for surgery, cannot safely undergo surgery, or continue to have pain after surgery.
It can be diagnostic. Temporary relief after numbing the nerve may help confirm that the nerve is part of the pain pathway.
It can be therapeutic. Medication around the nerve may reduce irritation and improve function in some patients.
It may guide shoulder RFA planning. A helpful block can support considering shoulder articular branch radiofrequency treatment in selected patients.
The shoulder has multiple pain pathways. The suprascapular nerve is important, but it is not the only nerve involved in shoulder pain.

Table of Contents

What Is the Suprascapular Nerve?

The suprascapular nerve is a nerve that travels from the neck region toward the shoulder blade and shoulder joint. It has both sensory and motor functions.

From a pain-treatment perspective, its sensory role is especially important. The suprascapular nerve contributes to pain signaling from the shoulder joint, including portions of the glenohumeral joint and acromioclavicular joint.

The nerve also supplies motor function to the supraspinatus and infraspinatus muscles, which are part of the rotator cuff. This is one reason the procedure should be performed thoughtfully: the goal is pain relief, not unnecessary motor weakness.

The suprascapular nerve may be targeted near the suprascapular notch, suprascapular fossa, spinoglenoid notch, or related shoulder blade landmarks depending on the purpose of the block, the physician’s technique, and the patient’s anatomy.

One Nerve, Many Shoulder Pain Stories

The suprascapular nerve can be involved in arthritis pain, rotator cuff-related pain, frozen shoulder pain, post-surgical pain, and post-replacement pain. The diagnosis determines how the block should be used.

What Shoulder Conditions May Benefit?

A suprascapular nerve block may be considered when chronic shoulder pain appears to involve the sensory nerve pathways around the shoulder joint and when the treatment result would help guide care.

Common situations include:

Shoulder osteoarthritis
Rotator cuff disease or chronic rotator cuff-related pain
Adhesive capsulitis, also called frozen shoulder
Post-shoulder replacement pain
Pain after shoulder arthroscopy or other shoulder surgery
Chronic shoulder pain in poor surgical candidates
Shoulder pain when repeated steroid injections are not ideal
Shoulder pain when physical therapy is limited by pain
Shoulder pain being evaluated for articular branch block or radiofrequency ablation
Selected cancer-related, traumatic, or complex shoulder pain patterns when appropriate

The block is not a replacement for a full shoulder diagnosis. Shoulder pain may come from the joint, rotator cuff, labrum, biceps tendon, cervical spine, brachial plexus, AC joint, scapular mechanics, or referred pain from other structures. The suprascapular nerve block works best when the clinical question is clear.

The Block Helps Answer a Question

The key question is not simply “Do you have shoulder pain?” The better question is: “Is the suprascapular nerve carrying a meaningful part of this shoulder pain signal?” A targeted block can help answer that question.

A Standalone Treatment for Chronic Shoulder Pain

In many patients, a suprascapular nerve block can be used as a standalone treatment. This is especially valuable when shoulder pain is chronic, function is limited, and surgery is not the best immediate option.

Patients who may especially benefit from this approach include:

Older patients with shoulder arthritis who are not ready for replacement
Patients who are medically poor surgical candidates
Patients with persistent pain after shoulder replacement
Patients with rotator cuff disease where surgery is not recommended or has limited expected benefit
Patients with frozen shoulder who cannot participate in therapy because pain is too intense
Patients trying to reduce repeated steroid exposure into the shoulder joint
Patients who need enough pain relief to improve sleep, mobility, dressing, hygiene, or therapy participation

The goal is usually functional improvement: better sleep, better range of motion, less pain with daily use, improved therapy tolerance, and reduced pain burden. It should not be presented as a cure for all structural shoulder disease.

Role in Shoulder Articular Branch Block and RFA Planning

The shoulder joint receives sensory input from multiple nerves. The suprascapular nerve is one of the major contributors, but shoulder pain may also involve the axillary nerve, lateral pectoral nerve, subscapular nerve, and other small articular branches depending on the region and diagnosis.

In selected chronic shoulder pain cases, especially arthritis or post-surgical pain, diagnostic blocks may be used to test whether articular sensory branches are carrying enough pain to justify a longer-acting treatment such as radiofrequency ablation.

In that setting, the suprascapular nerve block may be one piece of a larger shoulder denervation map. The exact plan depends on the pain location, shoulder diagnosis, prior surgery, anatomy, imaging, and response to diagnostic blocks.

Shoulder RFA Is a Map, Not a Guess

When suprascapular nerve block is used before shoulder RFA, the goal is to test whether the shoulder’s sensory nerve pathways are truly driving pain. A good diagnostic block helps decide whether longer-term nerve treatment makes sense.

Who May Benefit From a Suprascapular Nerve Block?

A suprascapular nerve block may be reasonable when the pain pattern fits shoulder joint or posterior-superior shoulder pain and when the result would help guide treatment.

Patients Who May Be Better Candidates

Patients with chronic shoulder pain from arthritis, rotator cuff disease, or adhesive capsulitis
Patients with persistent pain after shoulder replacement or shoulder surgery
Patients who are poor candidates for shoulder surgery
Patients who are not ready for shoulder replacement but need pain control
Patients whose shoulder pain limits physical therapy or daily function
Patients with pain over the posterior, superior, deep, or joint-related shoulder region
Patients being evaluated for shoulder articular branch block or shoulder RFA
Patients who need diagnostic clarification before a longer-term nerve pain plan is considered

Who May Not Be a Good Candidate?

A suprascapular nerve block may not be appropriate when the pain pattern does not fit the suprascapular nerve pathway, when another diagnosis clearly explains the symptoms, or when shoulder weakness or neurologic symptoms need a different workup.

Patients Who May Not Be Good Candidates

Patients with new traumatic shoulder deformity or suspected fracture/dislocation needing urgent evaluation
Patients with progressive arm weakness, severe numbness, or cervical myelopathy symptoms
Patients with severe cervical radiculopathy clearly explaining shoulder-region pain
Patients with active infection near the injection site
Patients with uncontrolled bleeding risk or unsafe anticoagulation status
Patients with widespread pain where one shoulder nerve block is unlikely to explain the main problem
Patients expecting one injection to permanently cure all shoulder pain or reverse arthritis

Shoulder Pain Red Flags Need Prompt Evaluation

New shoulder deformity after trauma
Suspected fracture or dislocation
Fever, chills, redness, warmth, or concern for joint infection
New arm weakness, hand weakness, or progressive numbness
Chest pain, shortness of breath, or symptoms concerning for heart or lung disease
History of cancer with new severe shoulder or bone pain
Rapidly worsening unexplained pain

What Happens During a Suprascapular Nerve Block?

A suprascapular nerve block is usually performed as an outpatient procedure. The exact target depends on whether the block is being used for general shoulder analgesia, diagnostic shoulder pain mapping, post-surgical pain, or articular branch/RFA planning.

Step 1: Evaluation and Target Selection

The physician reviews the shoulder diagnosis, pain location, range of motion, imaging, prior surgery, prior injections, therapy response, and possible competing sources such as cervical radiculopathy, AC joint pain, rotator cuff disease, or referred pain.

Step 2: Positioning

The patient is positioned so the shoulder blade and target region can be accessed safely. The position may vary depending on the approach and imaging method.

Step 3: Image-Guided Needle Placement

Ultrasound or fluoroscopic guidance may be used depending on the target, anatomy, and purpose of the block. The needle is guided toward the suprascapular nerve region or a related articular branch target.

Step 4: Medication Injection

The medication may include local anesthetic, steroid, or another medication depending on the purpose of the block and the patient’s condition. Local anesthetic may temporarily numb the painful nerve pathway.

Step 5: Response and Follow-Up

The patient should track how much relief occurred, how long it lasted, whether sleep improved, and whether shoulder movement or daily activities became easier. This information helps guide the next step.

Track Function, Not Just Pain

After a suprascapular nerve block, patients should notice whether they can sleep better, raise the arm more comfortably, dress more easily, tolerate therapy, or use the shoulder with less pain.

Why Image Guidance Matters

The suprascapular nerve travels near important shoulder blade landmarks, blood vessels, muscles, and the chest wall. Image guidance can help identify the target region and improve the accuracy of the injection.

Image guidance may help the physician:

Identify the suprascapular notch, suprascapular fossa, spinoglenoid region, or related articular target
Adjust for patient-specific anatomy
Place medication near the intended nerve pathway
Avoid nearby vessels when possible
Reduce the chance of testing the wrong pain pathway
Improve confidence that the block result is meaningful

Even with image guidance, the block is not perfect. Shoulder pain may involve the axillary nerve, lateral pectoral nerve, subscapular nerve, AC joint, glenohumeral joint, rotator cuff, biceps tendon, cervical spine, brachial plexus, or myofascial pain.

Shoulder Pain Has Multiple Wires

The suprascapular nerve is a major shoulder pain pathway, but it is not the only one. A good block helps clarify whether this pathway is important enough to guide treatment.

How Long Does Relief Last?

Relief after a suprascapular nerve block varies. Some patients feel relief only while the local anesthetic is active. Others may improve for days, weeks, or longer if nerve irritation or inflammation decreases.

The duration of relief depends on several factors:

Whether the suprascapular nerve is truly a major pain pathway
Whether the block reached the intended target
Whether steroid or another medication was used
Whether the shoulder has severe structural disease
Whether pain is coming from other shoulder nerves or articular branches
Whether pain is from rotator cuff disease, arthritis, frozen shoulder, post-surgical change, or another diagnosis
Whether physical therapy or activity modification becomes possible after pain improves

A short but strong response can be diagnostically meaningful. Longer relief may be therapeutic. No relief may suggest that the diagnosis, target, or pain pathway needs to be reconsidered.

What If the Suprascapular Nerve Block Helps?

If a suprascapular nerve block helps, the result may suggest that the suprascapular nerve is part of the shoulder pain pathway. The next step depends on how much relief occurred, how long it lasted, and whether shoulder function improved.

Possible next steps may include:

Observation if relief is strong and lasting
Physical therapy or restarting therapy once pain is quieter
Medication adjustment for shoulder or nerve pain
Repeat suprascapular nerve block in selected cases
Shoulder articular branch block planning
Shoulder radiofrequency ablation in selected chronic pain cases
Additional diagnostic blocks for axillary, lateral pectoral, or other shoulder articular branches when appropriate
Orthopedic follow-up if a structural problem still requires surgical evaluation
Further diagnostic work if multiple pain generators remain possible

Relief Gives Direction

A helpful suprascapular nerve block does not always mean the nerve is the only pain source. But it can show that this nerve pathway is important enough to guide the next step.

What If the Block Does Not Help?

If the block does not help, that information can still be useful. It may mean the suprascapular nerve is not the main pain generator, the target was not reached well enough, the pain is coming from another structure, or the problem involves more than one pathway.

When the block does not help, the plan may shift toward:

Rechecking the shoulder diagnosis and imaging
Considering AC joint, glenohumeral joint, rotator cuff, biceps tendon, or labral sources
Considering axillary nerve, lateral pectoral nerve, or other shoulder articular branches
Considering cervical radiculopathy, brachial plexus pain, or referred neck pain
Considering myofascial pain, scapular dyskinesis, or thoracic spine sources
Trying a different targeted diagnostic block if clinically appropriate

A Negative Block Is Still Information

If the familiar shoulder pain does not improve after a properly performed suprascapular nerve block, the diagnosis may need to move beyond that nerve pathway.

Suprascapular Nerve Block vs. Shoulder Joint Injection

A shoulder joint injection and a suprascapular nerve block are different procedures. They may both be used for shoulder pain, but they target different parts of the pain system.

Procedure	Typical Target	When It May Fit
Shoulder Joint Injection	Glenohumeral or AC joint space	Inflammation inside the joint, arthritis flare, adhesive capsulitis, or diagnostic joint source evaluation
Suprascapular Nerve Block	Major sensory nerve pathway to the shoulder	Chronic shoulder pain, poor surgical candidates, post-surgical pain, post-replacement pain, or shoulder RFA planning
Shoulder Articular Branch Block	Sensory branches from multiple shoulder nerves	Diagnostic mapping before shoulder radiofrequency treatment in selected chronic pain cases

Suprascapular Nerve Block vs. Interscalene Block

Patients sometimes hear about interscalene blocks for shoulder surgery and wonder whether that is the same as a suprascapular nerve block. They are different.

An interscalene block is a brachial plexus block commonly used for surgical anesthesia or postoperative pain control. It may numb much of the shoulder and arm, but it can also affect the phrenic nerve and breathing mechanics in some patients.

A suprascapular nerve block is more targeted to one important shoulder pain pathway. It is often used in pain medicine for chronic shoulder pain, diagnostic mapping, and selected non-surgical pain control.

The right choice depends on the clinical goal. A surgical anesthesia plan is different from chronic shoulder pain mapping.

When Shoulder Radiofrequency Ablation May Be Considered

Shoulder radiofrequency ablation may be considered in selected patients with chronic shoulder pain when diagnostic blocks suggest that shoulder sensory nerve pathways are driving pain and other treatments have not provided enough relief.

This may be especially relevant for:

Shoulder arthritis in patients avoiding or delaying surgery
Poor surgical candidates
Persistent pain after shoulder replacement
Chronic post-surgical shoulder pain
Patients who respond well to diagnostic shoulder nerve blocks but relief is temporary

Shoulder RFA is not appropriate for every shoulder pain patient. The shoulder is a complex joint with multiple sensory contributors. A careful diagnostic block strategy helps decide whether RFA is reasonable.

Block First, Then Decide

For chronic shoulder pain, a diagnostic block may help determine whether shoulder RFA is worth considering. The response should guide the plan, not the other way around.

Risks and Side Effects

Suprascapular nerve blocks are generally considered low-risk when performed carefully, but they are still medical procedures. Risks depend on the target, medication, patient anatomy, medical history, and whether image guidance is used.

Possible Side Effects and Risks Include:

Temporary soreness at the injection site
Bruising or bleeding
Temporary numbness, warmth, heaviness, or altered sensation around the shoulder
Temporary increase in shoulder pain
Temporary weakness or heaviness in shoulder movement
Infection, uncommon but possible
Nerve irritation or nerve injury, uncommon but possible
Allergic reaction to medication, uncommon but possible
Local anesthetic side effects
Vascular puncture or hematoma
Pneumothorax, or lung collapse, uncommon but important depending on target and depth
Failure to improve

Patients taking blood thinners or patients with bleeding disorders, infection, medication allergies, prior complex shoulder surgery, lung disease, or significant medical conditions should discuss risks carefully before the procedure.

Low Risk Does Not Mean No Risk

A suprascapular nerve block should have a clear purpose: to test or treat a suspected shoulder nerve pain pathway. The safest injection is one that answers a useful clinical question.

Recovery After the Block

Most patients go home the same day after a suprascapular nerve block. Some may notice temporary numbness, warmth, heaviness, or pain relief around the shoulder if local anesthetic is used.

Patients should be careful during the numb period. If the shoulder feels better, that does not mean the underlying tissue is ready for heavy lifting, aggressive exercise, or sudden overhead activity immediately.

General Recovery Tips

Track pain relief during the first few hours after the block.
Notice whether sleep, arm elevation, dressing, reaching, or therapy tolerance improves.
Avoid heavy lifting or aggressive shoulder activity immediately after the procedure.
Be cautious if the shoulder feels temporarily weak, numb, or heavy.
Follow medication and activity instructions provided by the physician.
Call the office if symptoms are severe, worsening, or unusual.

If the block is diagnostic, the early response is especially important. Patients should write down how much relief occurred, how long it lasted, and whether usual triggers such as reaching, lifting, dressing, sleeping on the shoulder, or therapy exercises improved.

Do Not Waste the Diagnostic Window

If the block is meant to help diagnose the pain source, the first few hours matter. Track whether the usual shoulder pain and usual shoulder movements improve while the nerve is numb.

How to Prepare for the Procedure

Preparation depends on the patient’s medical history, medications, planned technique, and whether sedation is used. Most blocks are outpatient procedures, but patients should still follow instructions carefully.

Before the Procedure

Tell the physician about blood thinners, aspirin, anti-inflammatory medications, and supplements.
Report any infection, fever, antibiotic use, or recent illness.
Tell the physician about medication allergies, contrast allergy, latex allergy, or prior reaction to injections.
Tell the physician about prior shoulder surgery, shoulder replacement, rotator cuff repair, fractures, or nerve injuries.
Bring or review relevant shoulder and neck imaging if available.
Ask whether you need a driver, especially if sedation is planned.
Ask what symptoms and movements to track after the injection.

Cost, Insurance, and Coverage

Insurance coverage for a suprascapular nerve block depends on the diagnosis, payer policy, documentation, medical necessity, medication used, image guidance, and whether prior authorization is required.

Some plans may cover this nerve block for selected diagnoses when medically necessary. Others may require additional documentation or may limit repeat procedures. Shoulder articular branch blocks and shoulder radiofrequency procedures may have separate coverage rules.

Patients should ask:

Is the suprascapular nerve block covered by my insurance?
Is prior authorization required?
What diagnosis is being used?
Is the block diagnostic, therapeutic, or both?
Will ultrasound or fluoroscopic guidance be used?
Will this be part of a shoulder RFA evaluation?
What are my out-of-pocket costs?
What happens if the block helps?
What happens if it does not help?

For treatments that are not covered or are self-pay, our office can discuss payment options. For eligible patients, CareCredit financing may be available depending on approval and available terms.

Questions to Ask Before a Suprascapular Nerve Block

Before the block, patients should understand what shoulder pain pathway is being tested and what the result will mean.

Helpful Questions Include:

Does my pain pattern fit the suprascapular nerve pathway?
Could this pain be coming from the shoulder joint, rotator cuff, AC joint, biceps tendon, cervical spine, brachial plexus, or another source?
Is the block diagnostic, therapeutic, or both?
Will ultrasound or fluoroscopic guidance be used?
What medication will be injected?
How much relief would count as a positive response?
How long should relief last?
Should I track pain, range of motion, sleep, or therapy tolerance?
Is this block being used as part of shoulder RFA planning?
What are the risks for my specific situation?
What are the next steps if the block helps?
What are the next steps if the block does not help?

The Best Question Before the Block

Ask: “What shoulder pain pathway are we testing, and what will we do differently depending on the result?” If the answer is clear, the block has a purpose.

Suprascapular nerve block is part of a broader shoulder and nerve pain care map. Patients with overlapping shoulder, neck, arm, or post-surgical symptoms may also benefit from related topics.

Frequently Asked Questions About Suprascapular Nerve Block

What is a suprascapular nerve block?

A suprascapular nerve block is an injection placed near the suprascapular nerve, a major nerve involved in shoulder pain. It may be used to diagnose or treat selected shoulder pain patterns.

What does a suprascapular nerve block treat?

This block may be considered for chronic shoulder pain, shoulder arthritis, rotator cuff-related pain, adhesive capsulitis, post-surgical shoulder pain, post-shoulder replacement pain, and shoulder pain in poor surgical candidates.

Is this block only for nerve pain?

No. The suprascapular nerve carries pain signals from shoulder joint structures. A patient may have arthritis, rotator cuff disease, or post-surgical shoulder pain, and the nerve block may still help reduce the pain signal.

Can it help after shoulder replacement?

It may help selected patients with persistent pain after shoulder replacement when the pain appears to involve shoulder sensory nerve pathways and other causes have been evaluated.

Can it help patients who cannot have shoulder surgery?

Yes. It can be useful for selected patients who are poor surgical candidates, not ready for surgery, or trying to manage chronic shoulder pain without a major operation.

Is suprascapular nerve block used before shoulder RFA?

It may be used as part of a shoulder articular branch block or radiofrequency ablation evaluation. A helpful diagnostic block may support considering longer-acting shoulder nerve treatment in selected cases.

How does the block work?

The block places medication near the suprascapular nerve pathway. Local anesthetic may temporarily numb the nerve, while steroid or another medication may reduce irritation or inflammation depending on the treatment plan.

Is the block diagnostic or therapeutic?

It can be both. If numbing the suprascapular nerve temporarily relieves the familiar shoulder pain, the block may help confirm the diagnosis. If relief lasts longer, it may also provide therapeutic benefit.

How long does relief last?

Relief varies. Some patients feel relief only for a few hours while the local anesthetic is active. Others may improve for days, weeks, or longer if nerve irritation or inflammation decreases.

What if the block helps only briefly?

A short but strong response may still be diagnostically meaningful. It may suggest that the suprascapular nerve is part of the shoulder pain pathway, even if longer-lasting treatment is needed.

What if the block does not help?

If the block does not help, the suprascapular nerve may not be the main pain source, or the pain may be coming from another structure such as the rotator cuff, AC joint, glenohumeral joint, biceps tendon, cervical spine, brachial plexus, or another shoulder nerve pathway.

Is image guidance used?

Ultrasound or fluoroscopic guidance may be used depending on the target, anatomy, and physician judgment. Image guidance can help identify shoulder landmarks and the intended nerve region.

Is the procedure painful?

Most patients feel a brief pinch, pressure, or soreness. The shoulder may feel temporarily numb, warm, heavy, or different after the injection.

What are the risks?

Risks may include soreness, bruising, bleeding, infection, temporary numbness, temporary pain flare, temporary shoulder heaviness or weakness, nerve irritation, nerve injury, allergic reaction, local anesthetic side effects, vascular puncture, hematoma, pneumothorax, and failure to improve.

Can the block be repeated?

It may be repeated in selected cases when the first block provides meaningful relief and the diagnosis supports repeating treatment. Repeat injections should have a clear purpose and should not continue indefinitely without benefit.

What are the next steps if the block works?

Next steps may include observation, physical therapy, medication adjustment, repeat block, shoulder articular branch block planning, shoulder radiofrequency ablation, or orthopedic follow-up depending on the response and diagnosis.

Is this nerve block covered by insurance?

Coverage depends on the diagnosis, payer policy, medical necessity, documentation, medication used, image guidance, and whether prior authorization is required.

Key Takeaways

A suprascapular nerve block targets one of the major sensory nerve pathways involved in shoulder pain.
It may help chronic shoulder pain from arthritis, rotator cuff disease, frozen shoulder, post-surgical pain, or post-replacement pain.
It is especially valuable for selected patients who are poor surgical candidates or still have pain after surgery.
It can be used as a standalone treatment or as part of shoulder articular branch block and RFA planning.
The suprascapular nerve is important, but shoulder pain can involve multiple nerves and structures.
A short but strong response can be diagnostically meaningful.
Longer relief may occur when nerve irritation or inflammation improves.
No relief may mean the diagnosis, target, or pain pathway needs to be reconsidered.
Image guidance can help identify landmarks and improve confidence in the target.
Next steps may include therapy, medication adjustment, repeat block, shoulder RFA, or orthopedic follow-up depending on the response.

Could the Suprascapular Nerve Be Driving Your Shoulder Pain?

Chronic shoulder pain can come from arthritis, rotator cuff disease, prior surgery, replacement, the cervical spine, or shoulder sensory nerves. The key is deciding which pathway is driving the pain.

At SpinePain Solutions, we evaluate the shoulder diagnosis, imaging, prior treatments, and pain pattern to decide whether a suprascapular nerve block, shoulder articular branch block, shoulder RFA, therapy, or another treatment makes sense.

Schedule a Consultation

This article is intended for educational purposes only and should not replace individualized medical advice. Shoulder pain, rotator cuff disease, shoulder arthritis, adhesive capsulitis, post-surgical shoulder pain, post-replacement pain, cervical radiculopathy, brachial plexus pain, and other shoulder-region pain conditions can have multiple causes. New, severe, unexplained, traumatic, infectious, neurologic, chest-related, or rapidly worsening symptoms should be evaluated promptly. Treatment decisions should be based on a complete history, physical examination, imaging review when appropriate, diagnosis, risks, benefits, alternatives, and a discussion with your physician.