Efficacy of ultrasound-guided suprascapular nerve block treatment in patients with painful hemiplegic shoulder

Aydın, Tuğba; Şen, Ekin İlke; Yardımcı, Merve Yıldız; Kesiktaş, Fatma Nur; Öneş, Kadriye; Paker, Nurdan

doi:10.1007/s10072-019-03749-y

Cited by 26 publications

(27 citation statements)

References 15 publications

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“…SSN nerve block with local anesthetic and/or steroid has been shown to be effective in treating shoulder pain. [ 19 , 20 , 22 ] This treatment has been efficacious in various shoulder pathologies including supraspinatus tendinopathy, frozen shoulder, and nonspecific shoulder pain. [ 23 , 24 ] In our research, blocking the articular branches of the SSN and SC nerve also resulted in effective functional improvement and pain reduction in shoulder pain caused by various pathologies.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of new nerve blocks method on the articular branches of the suprascapular and subscapular nerves to treat shoulder pain

2020

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To evaluate the effectiveness and safety of performing nerve blocks on the articular branches of the suprascapular and subscapular nerves for the treatment of shoulder pain caused by various pathologies. Fifty-two patients with shoulder pain were included in this study. Suprascapular and subscapular nerve blocks were performed with 2.5 mL anesthetic solution (2 mL of 0.5% bupivacaine and 0.5 mL of 2 mg/mL dexamethasone). The subjects were evaluated before the procedure and 1, 3, and 6 months afterward by means of the numeric rating scale and the shoulder pain and disability index. A post-injection pain reduction of >50% and <50% was considered a positive and negative response to the blocks, respectively. After nerve blocks, the mean numeric rating scale and shoulder pain and disability index scores were significantly reduced from pre-injection values, and this effect persisted for 6 months after injection. The positive and negative response groups consisted of 31 (60%) and 21 (40%) patients, respectively. The positive response group showed significantly better outcomes on the numeric rating scale and shoulder pain and disability index compared with the negative response group. No patients reported adverse effects either during or after the procedure. Performing nerve blocks on the articular branches of the suprascapular and subscapular nerves resulted in positive outcomes for shoulder pain patients. Regardless of shoulder pathology, this new injection method can be safely used in shoulder pain patients.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of new nerve blocks method on the articular branches of the suprascapular and subscapular nerves to treat shoulder pain

2020

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“…For example, during the visualization of the extensor carpi radialis longus and brevis tendons in the short axis at the distal forearm, two echogenic reflections can be seen deep in the underlying cortical bone ( Figure 9 B). When a suprascapular nerve block is performed [ 29 ], the mirror artifacts of the supraspinatus muscle can be observed symmetrically on the other side of the scapular spine ( Figure 9 C). Artifacts can also be visualized when the Doppler mode is turned on to track a vessel overlying a bony cortex ( Figure 9 D).…”

Section: Attenuation Of Ultrasound Signalsmentioning

confidence: 99%

Artifacts in Musculoskeletal Ultrasonography: From Physics to Clinics

Chang

Hsu

et al. 2020

Diagnostics

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Ultrasound appears to be the most useful imaging tool in the diagnosis and guided treatment of musculoskeletal disorders. However, ultrasonography has been criticized for being user dependent. Therefore, medical professionals should be familiar with the basic principles of ultrasound imaging (e.g., physics and technical skills) to diminish artifacts and avoid misinterpretation. In this review, we focused on the physics of common artifacts, their clinical significance, and the ways to tackle them in daily practice during musculoskeletal imaging. In particular, artifacts pertaining to the focal zone, beam attenuation, path and side lobe of the beam, speed of the sound, and range ambiguity were described.

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“…In recent years, various injection therapies have been proposed in its management. For instance, suprascapular nerve block (SSNB) using local anesthetics can be performed to decrease nociception from the glenohumeral joint [ 11 ]. Intramuscular botulinum toxin (BoNT) injections are also effective in reducing spasticity of the hemiplegic limbs and the associated pain [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis

Chiu

Chang

et al. 2021

Pharmaceuticals

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Hemiplegic shoulder pain (HSP) hampers post-stroke functional recovery and is not well managed with conservative treatments. This systematic review aimed to examine the various injection therapies for HSP and investigate their effectiveness at different time points. The protocol of this meta-analysis was registered on INPLASY with a registration number of INPLASY202180010. PubMed, EMBASE, and Scopus were searched from their inception to 4 August 2021 for the clinical studies investigating comparative effectiveness of different injection regimens for treating hemiplegic shoulder pain in patients with stroke. The primary outcome was the weighted mean difference (WMD) on the visual analog scale (VAS) of pain reduction in the fourth-week and between the fourth and twenty-fourth weeks. Ranking probabilities of the WMD for each treatment were obtained using simulations. Seventeen studies with 595 participants were included. The network meta-analysis showed that at the fourth-week, intra-muscular botulinum toxin (BoNT) injections and suprascapular nerve blocks (SSNB) were superior to a placebo, with WMDs of 1.55 (95% CI, 0.09 to 3.01) and 1.44 (95% CI, 0.07 to 2.80), respectively. SSNB possessed the highest probability (53.3%) and appeared to be the best treatment in the fourth-week, followed by intra-muscular BoNT injections (42.6%). Intramuscular BoNT injections were better than the placebo, with a WMD of 1.57 (95% CI, 0.30 to 2.84) between the 4th and 24th weeks. Intramuscular BoNT injections had the highest probability (79.8%) as the best treatment between the 4th and 24th weeks. SSNB was likely to rank first in relieving HSP at the fourth post-treatment week, whereas intra-muscular BoNT injections had the highest probability to achieve the best treatment effectiveness in the post-injection period between the fourth and twenty-fourth weeks. However, as some of the included studies used a non-randomized controlled design, more randomized controlled trials are needed in the future to validate and better understand the short- and long-term efficacy of different injection therapies for management of HSP.

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Efficacy of ultrasound-guided suprascapular nerve block treatment in patients with painful hemiplegic shoulder

Cited by 26 publications

References 15 publications

Effectiveness of new nerve blocks method on the articular branches of the suprascapular and subscapular nerves to treat shoulder pain

Effectiveness of new nerve blocks method on the articular branches of the suprascapular and subscapular nerves to treat shoulder pain

Artifacts in Musculoskeletal Ultrasonography: From Physics to Clinics

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis

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