PITTSBURGH (KDKA) – Many people with chronic shoulder pain try physical therapy and medication to relieve their symptoms.

However, what if you could get medication directly to the area from where the pain is coming?

That’s the approach a local woman tried after dealing with pain for decades.

A car accident 30 years ago left Betsy Nero with chronic neck and shoulder pain.

“When you wake up in the morning and it starts in your neck and you feel it radiating to your arm, only mine doesn’t go away after a couple of days,” Nero, of Murrysville, said.

Working at her desk and turning her head while driving make the painful stiffness worse.

“I have tried physical therapy, medication, just different types of exercising, and each time it was temporary relief. An hour later it’s sore again,” Nero said.

Having failed first line treatments, Nero was referred by her primary doctor to a pain specialist who offered ultrasound guided injections, a combination of steroids and a local anesthetic.

Instead of injecting a large amount of medicine based only on surface landmarks, the doctor can use less medicine and give it more precisely. The target was the suprascapular nerve.

“You can visualize the nerves, you can visualize arteries,” Dr. ZongFu Chen, Pain Specialist at UPMC, said.

He is not aware of anyone else in the area using ultrasound guidance. He does about three cases a day like this. He finds his patients are better able to do their physical therapy.

This also helps to reduce their pain, which could be from a variety of conditions, such as rheumatoid arthritis, wear and tear arthritis, even rotator cuff injuries.

The procedure is covered by insurance. The doctor could accidentally puncture the lung or the nearby artery, but ultrasound minimizes these possibilities.

If you are allergic to the medications, this is not for you. If you take blood thinners, you will want to be cautious.

Nero has received three shots already and has seen good results.

“Honestly, I didn’t know what to expect, because I haven’t had much success,” Nero said.

It has been 10 months since her last injection, which is longer than the typical 2-to-3 month response.

“Ten months that I can honestly say I felt really good,” Nero said.

Typically someone can get a series of three or four shots. After that, other procedures to temporarily destroy the nerves for pain relief may be needed.

Nero realizes the injections can’t go on forever, but she hopes it has delayed the inevitable.

“I think the inevitable is surgery. I prefer to hold off as long as possible if there’s alternative means,” Nero said.

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