Comparison of the treatment efficacy of suprascapular nerve block and intra-articular shoulder injection techniques in patients diagnosed with adhesive capsulitis.

Abstract

Background: Adhesive capsulitis (AC) is a common cause of shoulder disability. Interventional procedures are used along with many other treatment methods. There are insufficient studies directly comparing the superiority of suprascapular nerve block (SSNB) and intra-articular shoulder injection (IAI) techniques, which are frequently used interventional methods in treatment.

Objective: To compare the efficacy of ultrasonography-guided SSNB and IAI techniques in terms of pain and functional status in the treatment of AC.

Design: A single-center, double-blind randomized study.

Setting: The study was conducted at the Physical Therapy and Rehabilitation outpatient clinic of Antalya Training and Research Hospital between March and October 2022.

Participants: Eighty-four participants aged 15 to 75 years with a clinical diagnosis of AC were screened for the study, and 60 participants were included in the study after excluding participants who did not meet the criteria.

Interventions: Participants were randomized into two groups with 30 participants in each group. Both groups received an injection of 1 mL of 40 mg of triamcinolone acetonide and 9 mL of 0.5% bupivacaine hydrochloride under ultrasonographic guidance.

Main outcome measures: The patients' Shoulder Pain and Disability Index (SPADI) scores, shoulder active and passive range of motions (ROM), and visual analog scale (VAS) scores were evaluated before and after the injection in the 1st week, 4th week, and 12th week.

Results: Our study found no significant difference in SPADI and ROM between the two groups when comparing pre-injection and post-injection results in 1st week, 4th week, and 12th week. When pre-injection and 1st week, 1st week and 4th week, 4th week and 12th-week measurements were compared, improvement in SPADI-Disability scores, SPADI-Total scores, active flexion, passive flexion, active abduction, passive abduction, and active extension ROM values continued until the 12th week in both groups. In both groups, improvement in SPADI-Pain scores, active external rotation, and passive external rotation ROM values continued until the 4th week. In terms of VAS scores, passive extension, active internal rotation, and passive internal rotation ROM values, there was a statistically significant improvement in both groups after the injection compared to pre-injection.

Conclusion: The efficacy of SSNB and IAI techniques in the treatment of adhesive capsulitis was found to be similar. In both methods, significant improvements were observed in SPADI, ROM, and VAS measurements compared to baseline.