Comparison of outcome of ultrasound-guided suprascapular nerve block versus intra-articular steroid injection in adhesive capsulitis of shoulder: A randomized control trial

Abstract

Background: Adhesive capsulitis (AC) is the most common cause of shoulder pain in India. There is little consensus regarding the optimal course of treatment for AC. The aim of the present study was to compare the effectiveness of ultrasound-guided suprascapular nerve block (USNB) with intra-articular steroid injection (IASI) in AC of shoulder in providing pain relief, functional improvement, and reduction of disabilities. Settings and Design: A prospective randomized control trial at a tertiary care hospital compared a single dose of IASI with USNB in patients having shoulder pain and stiffness secondary to AC of ≥12 weeks' duration, visiting Outpatient Department of Physical Medicine and Rehabilitation. Materials and Methods: Patients in the first group were given IASI (2 ml of 40 mg/ml triamcinolone) while in the other group received USNB (4 ml of 0.5% injection bupivacaine). Home-based therapeutic exercise program for AC was advised for both the groups. The outcome measures were the Shoulder Pain and Disability Index (SPADI) and passive range of motion (ROM) (flexion, abduction, and external rotation) of the affected shoulder. Follow-up was done at 1-week, 3-week, and 6-week time-points. Results: Both domains of SPADI (pain score and disability score) and passive shoulder ROM significantly improved (P 0.05). Conclusion: Suprascapular nerve block is comparable in efficacy to IASI in patient with AC.

Keywords

• Adhesive capsulitis of the shoulder
• intra-articular injection
• nerve block
• shoulder pain