Physiotherapist‐led suprascapular nerve blocks for persistent shoulder pain: Evaluation of a new service in the UK

Salt, Emma; Windt, Daniëlle A. van der; Chesterton, Linda S; Mainwaring, F.; Ashwood, Neil; Foster, Nadine E

doi:10.1002/msc.1205

Cited by 4 publications

(16 citation statements)

References 26 publications

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“…The condition was first diagnosed by Neviaser in 1945 [ 2 ], but the symptoms of this syndrome were identified in literature long before that. Adhesive shoulder capsulitis is present in 2% to 5% of the general population and in 20% of diabetes mellitus patients [ 1 , 3 ]. This disorder has several causes; idiopathic causes, diabetes mellitus, trauma, and history of shoulder joint manipulation after surgery are highly prevalent causes [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey

Mardani-Kivi

Nabi

Mousavi

et al. 2022

Clin Shoulder Elbow

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Background: Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy. Methods: This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a supracondylar nerve block performed with a single indirect injection of 8-mL lidocaine HCL1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy. The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention. Results: Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001).Conclusions: SSNB is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.

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Section: Introductionmentioning

confidence: 99%

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey

Mardani-Kivi

Nabi

Mousavi

et al. 2022

Clin Shoulder Elbow

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“…62 The lowest volume of local anaesthetic used was 1ml of 1% Ropivacaine combined with 1ml of Betamethasone delivered by ultrasound. 23 The largest volume of local anaesthetic used was 10ml of 0.5% Bupivacaine, 20,[39][40][41][42][43][44]55,64,68,70,71 10ml of 1% Lidocaine, 30,38,45,56,76 10ml of 2% Lidocaine 72 and 10ml of 2% Prilocaine 29 by both land-marked and ultrasound guided techniques. The largest dosage of local anaesthetics reported was 400mg of Lidocaine [4ml/10%] injected using EMG guidance, 48 200mg of Lidocaine [2ml/10%] injected using ultrasound guidance 32 and 200mg of Lidocaine [10ml/2%] delivered land-marked.…”

Section: Medication Usedmentioning

confidence: 99%

“…We included 53 studies from 14 different countries in this review (Table 1). Of which, 13 studies came from Turkey, [26][27][28][29][30][31][32][33][34][35][36][37][38] 7 each from Australia 20,23,39,38,39,[40][41][42][43] and India, [44][45][46][47][48][49][50] 6 from the United Kingdom, [51][52][53][54][55][56] 4 each from the United States [57][58][59][60] and South Korea, [61][62][63][64] 2 each from Brazil, 65,66 Canada, 67,68 Egypt 69,70 and Italy, 7...…”

Section: Study Characteristicsmentioning

confidence: 99%

“…76 We included 28 RCTs, 23,26,27,[29][30][31]33,35,36,38,[41][42][43][44]46,[48][49][50][51][52]55,57,61,67,68,70,72,76 21 observational studies, 20,28,32,34,37,39,45,53,54,57,58,[62][63][64][65][66]69,71,[73][74][75] 3 audits 40,59,60 and 1 service evaluation. 56 Participant numbers were generally small within the included RCTs ranging from 10 participants 76 to 100 participants.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Of these, the indirect surface land-marked approach was reported in 20 studies 20,36,[39][40][41][42][43][44]50,[53][54][55]57,65,68,69,72,[74][75][76] and the direct suprascapular notch surface land-marked approach was reported in 10 studies. 27,29,30,35,38,51,56,[59][60][61] In one study, the direct spinoglenoid notch method was used 45 and in one study, a combination of both the direct suprascapular notch and indirect method was used. 52 Ultrasound guidance used alone was reported in 16 studies.…”

Section: Types Of Publicationmentioning

confidence: 99%

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A systematic review of the methods and drugs used for performing suprascapular nerve block injections for the non-surgical management of chronic shoulder pain

Smith

Liew

Johnson

et al. 2021

British Journal of Pain

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Suprascapular nerve block (SSNB) injections are growing in popularity as a treatment option for people with chronic shoulder pain. The optimal method of injection and aftercare is unknown. This review describes the current methods and drugs used for performing SSNB injections in the non-surgical management of adults with chronic shoulder pain in order to inform future research in this area. Systematic searches of CINAHL, MEDLINE (OVID), AMED, Embase databases and the Cochrane Library were undertaken from inception to June 2020. Data on the method and drugs used for injection and aftercare were extracted and summarised for areas of commonality and discrepancy. We included 53 studies in this review. In total, eight different injection methods were reported within the included studies. Indirect surface land-marked methods were the most common method reported in 21 studies. Direct surface land-marked methods were reported in 12 studies. Ultrasound-guided methods used alone were reported in 16 studies. Both fluoroscopy and computed tomography methods used alone were reported in one study each. Electromyography was used in combination with other injection methods in nine studies. Wide variation in the composition of the injectate was observed between studies. Local anaesthetic was used within injectate preparations in all studies. Local anaesthetic used alone was reported in 20 studies, combined with steroid in 29 studies and combined with various other components in 5 studies. Physiotherapy following injection was reported in 26 studies. Reported details of physiotherapy varied considerably. This review identified substantial variation in the methods and drugs used to perform SSNB injection in clinical trials. Current literature demonstrates a wide range of methods used for SSNB injection administration. Consensus research defining standardised practice for SSNB injection is now needed to guide future clinical practice and research.

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Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review

et al. 2021

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ObjectivesIn response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK.DesignA scoping review was undertaken following JBI methodological guidance.Methods13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative.Results191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway.ConclusionThis review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.

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Physiotherapist‐led suprascapular nerve blocks for persistent shoulder pain: Evaluation of a new service in the UK

Abstract: The results provide early, exploratory evidence that patients with persistent shoulder pain treated by physiotherapists using palpation-guided SSNBs achieve clinically important changes in pain and function in the short and medium term.

Cited by 4 publications

References 26 publications

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey

A systematic review of the methods and drugs used for performing suprascapular nerve block injections for the non-surgical management of chronic shoulder pain

Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review

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