A Dual-Treatment Approach for Degenerative Shoulder Pain: Coracohumeral Ligament Release and Peripheral Nerve...

Chronic degenerative shoulder pain, often due to adhesive capsulitis or osteoarthritis, is challenging to treat. Total shoulder arthroplasty is an option when conservative treatment fails to alleviate symptoms, but many patients are unsuitable surgical candidates and require alternative treatment plans.

This case report presents a successful treatment approach combining coracohumeral ligament release and peripheral nerve stimulation (PNS). A 77-year-old patient with myelomalacia and progressive shoulder pain was found to have limited range of motion (ROM) and severe shoulder arthritis. He underwent multiple treatments over 4 years, including percutaneous tenotomy, corticosteroid injections, and stellate ganglion blocks. While his shoulder mobility improved, pain persisted. A PNS trial reduced pain by 80%, leading to permanent neurostimulator implantation.

This case highlights the potential of a sequential approach: first restoring ROM via ligament release, then managing pain with PNS as an effective alternative for patients ineligible for shoulder arthroplasty.