Comparative study of ultrasound guided supra-scapular nerve block versus intra-articular steroid injection in frozen shoulder

Abstract

<p class="abstract"><strong>Background:</strong> Frozen shoulder is one of the most common musculoskeletal problems seen in orthopaedics. Many treatment modes are available however, it is difficult to treat and data on the comparative efficacy of various interventions are limited. Intra-articular corticosteroid injection (IASI) is a commonly used to treat frozen shoulder pain. Supra-scapular nerve block (SSNB) is also effective method to treat pain in chronic diseases that affect the shoulder. The present study was done to compare efficacy of ultrasound guided SSNB and IASI in management of painful frozen shoulder.</p><p class="abstract"><strong>Methods:</strong> 60 patients with painful frozen shoulder were divided in two groups, Group A received ultra-sound guided SSNB with 6 ml 0.5% Bupivacaine; Group B received IASI using 40 mg Triamcinolone. Outcome measures were shoulder ranges mainly lateral rotation and abduction, shoulder pain and disability index and visual analogue scale (VAS). Patients were followed-up on 2<sup>nd</sup> day, at 1<sup>st</sup>, 3<sup>rd</sup> and 6<sup>th</sup> week.<strong></strong></p><p class="abstract"><strong>Results:</strong> All baseline parameters improved significantly in both groups; however, on comparison Group A showed significant improvement in passive lateral rotation on 2<sup>nd</sup> day and 1<sup>st</sup> week follow up (P =0.038 and 0.040 respectively). VAS score showed significance at all follow-up in Group A, whereas, in Group B significance was seen after 1 week. On inter group comparison Group A shows significance on 2<sup>nd</sup> day (P =0.050), 1<sup>st</sup> week (P =0.042) and 3<sup>rd</sup> week (P =0.036).</p><strong>Conclusions:</strong>Both SSNB and IASI have efficacy in management of frozen shoulder. But supra-scapular nerve block is better than intra-articular injection and should be considered prior to steroid as it has early onset pain relief, early improvement in ranges, potentially lesser contraindications and side effects.<p> </p>

Comparative Study of Effectiveness of Ultrasound-Guided Suprascapular Nerve Block Versus Intra-Articular Steroid Injection in the Management of Adhesive Capsulitis: A Randomised Controlled Trial in a Tertiary Care Hospital in Northeast India

“…[16,17] The total number of right side shoulder affected was 47(78.3%) and left side was 13(21.7%) which was comparable to a study conducted by Sonune SP et al in 2016. [18] In the study 31 patients out of 60 (51.7%) had associated diabetes. Our finding was higher as compared to the study.…”

“…In the present study, passive range of motion improved from baseline to subsequent follow up which was similar with other study. [18] There were both statistically and clinically significant reduction in pain and disability. VAS score improved significantly in both groups however improvement was significantly more in the study group at 4 weeks follow-up as compared to the control group which was comparable with other studies.…”

“…Our finding was higher as compared to the study. [18] This could be because of the difference in settings and background characteristics of the study participants. In the present study, passive range of motion improved from baseline to subsequent follow up which was similar with other study.…”

“…VAS score improved significantly in both groups however improvement was significantly more in the study group at 4 weeks follow-up as compared to the control group which was comparable with other studies. [16][17][18] SPADI score improved significantly in both groups however improvement was significantly more in the study group at 4 weeks follow-up as compared to the control group. Our study results for SPADI score were comparable with other studies showing the efficacy of suprascapular nerve block in shoulder pain management.…”

“…Our study results for SPADI score were comparable with other studies showing the efficacy of suprascapular nerve block in shoulder pain management. [16,18,19]…”