Comparing Three Modalities of Treatment for Frozen Shoulder: A Prospective, Double-Blinded, Randomized Control Trial

Parashar, Aakash; Goni, Vijay; Neradi, Deepak; Guled, Uday; Rangasamy, Karthick; Batra, Yatindra Kumar

doi:10.1007/s43465-020-00201-8

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…Sencan et al ( 9 ) found that compared with SSNB or intra-articular shoulder injection (IAI), a combination of SSNB and IAI can reduce the VAS of HSP patients, although not different statistically, but the function of the shoulder improves significantly. Parashar et al ( 23 ) divided 60 patients into three groups and found that SSNB in combination with non-invasive rehabilitation (NIR) is much more effective than either SSNB or NIR. One of the earliest studies about frozen shoulder also found that treatment with SSNB plus electroacupuncture is superior than any single one ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis

et al. 2021

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Purpose: We aimed to investigate the effectiveness of suprascapular nerve block (SSNB) in patients with hemiplegic shoulder pain (HSP).Background: SSNB is widely used in various shoulder pains, but whether it is effective in HSP remains unknown.Methods: PubMed, Cochrane Library, and Embase databases were searched to identify potential citations. Randomized controlled trials meeting the eligible criteria were included in our analysis. The primary endpoint was Visual Analog Scale (VAS) with a maximum value of 100 and a minimum value of 0. Secondary endpoints were passive range of motion (PROM) that pain starts, and the PROM mainly included abduction, flexion, and external rotation. In addition, the upper extremity Fugl-Meyer assessment (FMA) was also included in our secondary endpoints.Results: Eight studies with 281 patients were included in our analysis. For VAS, there was no obvious difference between SSNB group and control group regardless of the follow-up period (<4 weeks or ≥4 weeks), which were −6.62 (−15.76, 2.53; p = 0.16) and 1.78 (−16.18, 19.74; p = 0.85). For shoulder function, the PROM of abduction, flexion, and external rotation was similar between groups. However, motor function indicator FMA is lower in SSNB control than that in control group, with a mean difference (and 95% CI) of −2.59 (−4.52, −0.66; p = 0.008).Conclusion: SSNB is an effective way for HSP patients.Systematic Review Registration: Registration ID: CRD42021252429.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis

et al. 2021

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“… 12 However, when comparing effectiveness of different treatments, it would be useful to ensure the treatment locations are known to allow conclusions to be drawn from the results. Parashar et al 11 reports improved pain and disability outcome scores at three months with SSNB which is promising, but further assessment of the two treatment methods is required with standardization of the guidance and pharmacological intervention to allow true comparison. Therefore, a RCT taking these changes into account in a UK population is required.…”

Section: Introductionmentioning

confidence: 99%

“…10 To our knowledge, there has been no previous trial in secondary care comparing the effect of a single GHJ corticosteroid injection versus SSNB in the treatment of frozen shoulder with the same corticosteroid and local anaesthetic mixture. A randomized controlled trial (RCT) has been performed previously comparing SSNB and intra-articular GHJ injection, 11 but did not standardize the treatments, using a different type and volume of local anaesthetic. The GHJ injection also included a large proportion of saline as opposed to local anaesthetic.…”

Section: Introductionmentioning

confidence: 99%

A randomized clinical trial of glenohumeral joint steroid injection versus suprascapular nerve block in patients with frozen shoulder: a protocol for the Therapeutic Injections For Frozen Shoulder (TIFFS) study

et al. 2023

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AimsFrozen shoulder is a common, painful condition that results in impairment of function. Corticosteroid injections are commonly used for frozen shoulder and can be given as glenohumeral joint (GHJ) injection or suprascapular nerve block (SSNB). Both injection types have been shown to significantly improve shoulder pain and range of motion. It is not currently known which is superior in terms of relieving patients’ symptoms. This is the protocol for a randomized clinical trial to investigate the clinical effectiveness of corticosteroid injection given as either a GHJ injection or SSNB.MethodsThe Therapeutic Injections For Frozen Shoulder (TIFFS) study is a single centre, parallel, two-arm, randomized clinical trial. Participants will be allocated on a 1:1 basis to either a GHJ corticosteroid injection or SSNB. Participants in both trial arms will then receive physiotherapy as normal for frozen shoulder. The primary analysis will compare the Oxford Shoulder Score (OSS) at three months after injection. Secondary outcomes include OSS at six and 12 months, range of shoulder movement at three months, and Numeric Pain Rating Scale, abbreviated Disabilities of Arm, Shoulder and Hand score, and EuroQol five-level five-dimension health index at three months, six months, and one year after injection. A minimum of 40 patients will be recruited to obtain 80% power to detect a minimally important difference of ten points on the OSS between the groups at three months after injection. The study is registered under ClinicalTrials.gov with the identifier NCT04965376.ConclusionThe results of this trial will demonstrate if there is a difference in shoulder pain and function after GHJ injection or SSNB in patients with frozen shoulder. This will help provide effective treatment to patients with frozen shoulder.Cite this article: Bone Jt Open 2023;4(3):205–209.

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“…3,4 The reported indications for an SScNB are many, including for intra-and post-operative pain control, 5,6 for procedural analgesia whilst reducing shoulder dislocations 7 or in chronic conditions such as rheumatoid arthritis, 8 osteoarthritis 8,9 and frozen shoulder. 4,10 Due to the multiple clinical benefits of an SScNB we intend to assess, in a cadaveric study whether a landmark based technique can be used to effectively administer anaesthesia to the SScN. Furthermore, in this study we will assess if novice injectors can effectively administer an SScNB following minimal guidance.…”

Section: Introductionmentioning

confidence: 99%

The suprascapular nerve block (SScNB) is easily administered using a landmark-based technique: A cadaveric study to assess nerve staining post-injection

2023

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Aims The suprascapular nerve is an ideal target for nerve blockade to alleviate shoulder pain given its widespread innervation to the shoulder girdle. To widen availability of this treatment, we investigate whether an anatomical landmark technique can be adopted by novice injectors to provide efficacious blockade. Methods Five injectors were recruited with varying experience. 10 shoulders of Thiel embalmed cadavers were injected with blue dye. Written instructions and an illustration of the Dangoisse landmark technique were provided prior to injection. Cadavers were dissected and the presence or absence of dye staining reported by three observers and a consensus agreement reached. Results Dissection demonstrated diffuse staining in the suprascapular fossa. 90% of shoulders had adequate staining of the suprascapular nerve directly, or distal branches, which would provide adequate anaesthesia. Inter-observer agreement was good (k = 0.73) for staining at the supraspinous fossa and excellent (k = 0.87) for staining distally. The technique was performed by novice injectors with a good success rate. Conclusion This technique is reproducible by a range of clinicians to effectively provide anaesthesia of the SScN. Within a resource strained healthcare environment greater uptake of this technique is likely to be of benefit to a wider group of patients.

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Comparing Three Modalities of Treatment for Frozen Shoulder: A Prospective, Double-Blinded, Randomized Control Trial

Cited by 10 publications

References 20 publications

Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis

Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis

A randomized clinical trial of glenohumeral joint steroid injection versus suprascapular nerve block in patients with frozen shoulder: a protocol for the Therapeutic Injections For Frozen Shoulder (TIFFS) study

The suprascapular nerve block (SScNB) is easily administered using a landmark-based technique: A cadaveric study to assess nerve staining post-injection

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