Background and Aims Cryoneurolysis delivered via a cryoprobe for the treatment of acute and chronic pain has been described as far back as 1961.¹It has previously been described as a treatment for chronic shoulder pain via a landmark technique and acute post-operative shoulder pain via ultrasound guided technique.^2–3However, it’s application via ultrasound guidance for chronic shoulder pain has yet to be described.

Methods This is a case series of three adult patients who had chronic shoulder pain. All patients had previous landmark-based injections of their suprascapular nerve by their orthopedic surgeon using lidocaine that resulted in pain relief.Patients were seated on the edge of the bed and the suprascapular nerve was identified in the suprascapular notch via ultrasound using a 10–5 MHz probe.Then a 20-gauge 90 mm cryoprobe was advanced in plane in a medial to lateral direction until contact with the suprascapular nerve was obtained. A 106 second treatment cycle was started where an ice ball the size of 7.1 mm wide by 16.0 mm tall was performed.The treatment reached a temperature of -88 Celsius and resulted in second degree temporary nerve degeneration.

Results All patients had immediate pain relief with pain reduction to 0.Motor weakness lasted from 14–18 days.Follow up phone calls showed a duration of pain relief of 3–6 months.No adverse events were observed.

Conclusions Ultrasound guided cryoneurolysis may have a place in the management of chronic shoulder pain with a duration of pain relief from 3–6 months and motor weakness subsiding by 3 weeks post treatment.