Suprascapular Nerve Block for Shoulder Pain in the First Year After Stroke

Adey‐Wakeling, Zoe; Crotty, Maria; Shanahan, E. Michael

doi:10.1161/strokeaha.113.002471

Cited by 50 publications

(41 citation statements)

References 39 publications

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“…In our study, it is clearly seen that suprascapular nerve block is effective for pain management in case of hemiplegic shoulder pain. The results were found similar and comparable with Adey-Wakeling et al 22 The pain reduction was seen with more than >20 mm reduction in VAS scale at 1 st week with suprascapular nerve block. Also the VAS scale improved significantly at each follow up with comparable results.…”

Section: Discussionsupporting

confidence: 87%

Ultra-Sound Guided Suprascapular Nerve Block in Hemiplegic Shoulder Pain

Sonune¹,

Gaur²,

Gupta³

2018

jebmh

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BACKGROUND Hemiplegic shoulder pain is associated with reduced functional improvement, a higher incidence of depression, interference with rehabilitation, and an increased length of hospitalisation. Supra-Scapular Nerve Block (SSNB) has shown efficacy in various chronic shoulder pain management but lacks clinical evidence in case of hemiplegic shoulder pain management. MATERIALS AND METHODS A prospective randomised controlled trial was done to look for the efficacy of suprascapular nerve block in hemiplegic shoulder pain which included 60 patients divided in to two groups. Group A received ultra-sound guided suprascapular nerve block and exercise therapy (n=30); Group B received exercise therapy alone (n=30). Pain outcome was measured using Visual Analogue Scale (VAS) at rest and at movement of affected shoulder at 1 st week, 4 th week and 12 th week. RESULTS The VAS score, both at rest and at movement, improved significantly in group A with p-value 0.000 which was evident at 1st week post injection. The improvement in VAS score at rest is from 4.67 ± 1.42 to 1.53 ± 1.93 and in VAS score at movement is from 7.53 ± 1.50 to 2.37 ± 1.97 in group A. CONCLUSION Therefore, we conclude that SSNB is a safe and effective treatment option for patients with hemiplegic shoulder pain in the first year after stroke. The intervention can be easily performed using ultra-sound guidance in clinical settings, offering a practical and important advancement for shoulder pain management in this patient population.

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Section: Discussionsupporting

confidence: 87%

Ultra-Sound Guided Suprascapular Nerve Block in Hemiplegic Shoulder Pain

Sonune¹,

Gaur²,

Gupta³

2018

jebmh

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“…A recent randomized, clinical trial showed that suprascapular nerve blocks were superior to placebo injections in reducing hemiplegic shoulder pain for up to 12 weeks after treatment. 145,146 In another small, comparison study of patients with nonneuropathic hemiplegic shoulder pain, suprascapular nerve blocks were as effective as glenohumeral triamcinolone injections. 147 Surgical tenotomy of the pectoralis major, lattisimus dorsi, teres major, and subscapularis muscles may reduce pain in patients with severe hemiplegia and restrictions in shoulder range of motion.…”

Section: Assessment Prevention and Treatment Of Hemiplegic Shouldermentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,187

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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“…In a randomized placebo-controlled trial by AdeyWakeling et al, [23] blinded application of SSNB has been reported to be a safe and effective treatment for patients with HSP.…”

Section: Discussionmentioning

confidence: 99%

Blinded and stimulator guided comparison of suprascapular nerve block in hemiplegic shoulder pain: a pilot study

Külcü¹,

Taraktaş²,

Badur³

et al. 2017

Turk J Phys Med Rehab

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Objectives: This study aims to compare the superiority of different suprascapular nerve block (SSNB) application methods on hemiplegic shoulder pain (HSP), in a blinded and stimulator guided manner. Patients and methods:Twenty-six stroke patients (19 males, 7 females; mean age 61.0±9.4 years; range 53 to 76 years) meeting the enrollment criteria, were included in this study between September 2014 and November 2014. Patients were randomly divided into two equal groups. Patients in group A received blinded SSNB and patients in group B received stimulator guided SSNB. Range of motion (ROM) (by goniometer) and pain levels (by visual analog scale-VAS) were assessed. Evaluations were made before, one hour after and one week after SSNBs. Results:In each group, VAS pain scores significantly decreased over time (p<0.0001) and a significant increase in terms of flexion and abduction ROM angles (group A: p=0.002 and p=0.010; group B: p=0.004 and p=0.012, respectively) was observed. In addition, internal rotation ROM angles were found to have increased in group B (p=0.036). There were no significant differences in ROM and VAS one hour and one-week change scores between the two groups (p>0.05). Conclusion:Both blinded or stimulator guided suprascapular nerve block techniques were safe and effective for pain relief in hemiplegic shoulder pain management. None of the injection techniques was superior to the other.Keywords: Blinded; hemiplegic shoulder pain; stimulator guided; suprascapular nerve block.Hemiplejik omuz ağrısında kör ve stimülatör kılavuzluğunda supraskapular sinir blokajının karşılaştırılması: Pilot çalışma ÖZ Amaç: Bu çalışmada hemiplejik omuz ağrısında (HOA) kör ve stimülatör kılavuzluğunda, farklı supraskapular sinir blokajı (SSSB) uygulama yöntemlerinin birbirlerine üstünlüğü araştırıldı. Hastalar ve yöntemler:Eylül 2014 -Kasım 2014 tarihleri arasında yapılan bu çalışmaya katılma kriterlerini karşılayan 26 inme hastası (19 erkek, 7 kadın; ort. yaş 61.0±9.4 yıl; dağılım 53-76 yıl) dahil edildi. Hastalar randomize olarak iki eşit gruba ayrıldı. Grup A'daki hastalara kör SSSB, grup B'deki hastalara ise stimülatör kılavuzluğunda SSSB verildi. Eklem hareket açıklığı (EHA) (gonyometre ile) ve ağrı düzeyleri (görsel analog ölçeği-GAÖ ile) değerlendirildi. Ölçümler SSSB öncesinde, bir saat sonrasında ve bir hafta sonrasında yapıldı. Bulgular:Her iki grupta GAÖ ağrı skorlarında zamanla anlamlı olarak azalma (p<0.0001); fleksiyon ve abdüksiyon EHA açılarında (sırasıyla grup A: p=0.002 ve p=0.010; grup B: p=0.004 ve p=0.012) ise anlamlı artış gözlendi. Ek olarak grup B internal rotasyon EHA açılarında artış saptandı (p=0.036). Gruplar arasında, GAÖ ve EHA açıları bir saatlik ve bir haftalık değişim skorlarında anlamlı bir farklılık yoktu (p>0.05).Sonuç: Kör ya da stimülatör kılavuzluğunda yapılan supraskapular sinir blokajı tekniklerinin her ikisi de güvenli ve hemiplejik omuz ağrısı tedavisinde ağrının giderilmesinde etkilidir. Hiçbir enjeksiyon tekniği diğerinden üstün değildir.Anahtar sözcükler: Kör; hemiple...

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Suprascapular Nerve Block for Shoulder Pain in the First Year After Stroke

Cited by 50 publications

References 39 publications

Ultra-Sound Guided Suprascapular Nerve Block in Hemiplegic Shoulder Pain

Ultra-Sound Guided Suprascapular Nerve Block in Hemiplegic Shoulder Pain

Guidelines for Adult Stroke Rehabilitation and Recovery

Blinded and stimulator guided comparison of suprascapular nerve block in hemiplegic shoulder pain: a pilot study

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