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Updated: Jun 21, 2025

Functional and Morphological Assessment of Diaphragm Innervation by Phrenic Motor Neurons
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Phrenic Nerve Block for Diaphragmatic Pain: Case Report.

Chanon Thanaboriboon1,2,3, Marta A Vargas4, Konstantinos Alexopoulos2

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Summary

Phrenic nerve blocks can alleviate chronic shoulder pain caused by diaphragmatic irritation. This ultrasound-guided procedure offered significant pain relief and reduced opioid use in two patients with chronic pain.

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Area of Science:

  • Pain Medicine
  • Neurology
  • Medical Imaging

Background:

  • Referred shoulder pain is often linked to diaphragmatic irritation.
  • Phrenic nerve blockade is documented for acute pain but not chronic pain conditions.
  • Chronic diaphragmatic irritation can cause persistent ipsilateral shoulder pain.

Observation:

  • Two cases of chronic diaphragmatic irritation presenting with ipsilateral referred shoulder pain were analyzed.
  • Patients underwent ultrasound-guided phrenic nerve blockade.
  • Pain levels and opioid consumption were monitored before and after the procedure.

Findings:

  • Ultrasound-guided phrenic nerve block provided significant pain relief in both patients.
  • A notable reduction in opioid consumption was observed post-procedure.
  • This intervention shows promise for managing chronic referred shoulder pain.

Implications:

  • Phrenic nerve blockade is a potential therapeutic option for chronic shoulder pain stemming from diaphragmatic issues.
  • Further research is warranted to establish the efficacy and safety profile for chronic pain management.
  • Careful patient selection and risk-benefit assessment are crucial before implementing this technique.