Ann Rehabil Med.  2014 Apr;38(2):167-173.

The Comparison of Effects of Suprascapular Nerve Block, Intra-articular Steroid Injection, and a Combination Therapy on Hemiplegic Shoulder Pain: Pilot Study

• Jeon WH
• Park GW
• Jeong HJ
• Sim YJ

Abstract

OBJECTIVE
To assess the relative effectiveness of three injections methods suprascapular nerve block (SSNB) alone, intra-articular steroid injection (IAI) alone, or both-on relief of hemiplegic shoulder pain.
METHODS
We recruited 30 patients with hemiplegic shoulder pain after stroke. SSNB was performed in 10 patients, IAI in 10 patients, and a combination of two injections in 10 patients. All were ultrasonography guided. Each patient's maximum passive range of motion (ROM) in the shoulder was measured, and the pain intensity level was assessed with a visual analogue scale (VAS). Repeated measures were performed on pre-injection, and after injection at 1 hour, 1 week, and 1 month. Data were analyzed by Kruskal-Wallis and Friedman tests.
RESULTS
All variables that were repeatedly measured showed significant differences in shoulder ROM with time (p<0.05), but there was no difference according injection method. In addition, VAS was statistically significantly different with time, but there was no difference by injection method. Pain significantly decreased until a week after injection, but pain after a month was relatively increased. However, pain was decreased compared to pre-injection.
CONCLUSION
The three injection methods significantly improved shoulder ROM and pain with time, but no statistically significant difference was found between them.

Keyword

Stroke; Shoulder pain; Nerve block; Intra-articular injections

MeSH Terms

Humans
Injections, Intra-Articular
Nerve Block*
Pilot Projects*
Range of Motion, Articular
Shoulder
Shoulder Pain*
Stroke
Ultrasonography

Figure

• 

  Fig. 1 Changes in passive range of motion (ROM) after injection with time. (A) Changes in passive flexion ROM after injection with time. (B) Changes in passive abduction ROM after injection with time. (C) Changes in passive external rotation ROM after injection with time. (D) Changes in passive internal rotation ROM after injection with time. IAI, intra-articular steroid injection; SSNB, suprascapular nerve block; combined, IAI+SSNB.

• 

  Fig. 2 Changes in visual analogue scale (VAS) after injection with time. IAI, intra-articular steroid injection; SSNB, suprascapular nerve block; combined, IAI+SSNB.

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