Suprascapular Nerve Block Effective in Treatment of Frozen Shoulder
Frozen shoulder or adhesive capsulitis is a common problem in general practice presenting as pain that may be severe and as a progressive loss of movement resulting in a loss of function. A recent study suggests that suprascapular nerve block (SSNB) is highly effective in reducing the duration of frozen shoulder. The study findings were presented at the ACR Convergence 2021 and published in the American College of Rheumatology on November 19, 2021.
Pain relief and restoration of normal shoulder function are the common aims of the treatment in frozen shoulder. The regional nerve block is effective for managing acute or chronic pain. Among various nerve block techniques, a suprascapular nerve block is an effective, simple, and practical method for the management of shoulder pain. Prof Ernst Shanahan and his team conducted a study to investigate the value of suprascapular nerve block (SSNB) as a treatment option for adhesive capsulitis.
It was a randomized, double-blind placebo-controlled study. The researchers included a total of 54 patients (19 male, 35 female) with adhesive capsulitis and randomized 27 patients to receive standard therapy plus placebo (3 mls of subcutaneous normal saline) and another 27 patients to standard therapy plus SSNB (10 mls of 0.5% bupivacaine and 40 mg of depomedrol). Standard therapy comprised an intra-articular glenohumeral joint injection of 20 mg of triamcenolone at time zero, plus a physiotherapist supervised exercise program. Patients were treated at baseline and then at 3 monthly intervals until resolution. They determined resolution as a return to a full range of movement and a reduction of pain scores to normal, or recovery to the satisfaction of the patient. They measure pain, disability, range of movement and patient-perceived rate of recovery scores at 12 weekly intervals in the two groups.
Key findings of the study were:
- Upon analysis, the researchers found that the meantime to the resolution of symptoms was 5,4 months in the active group versus 11.2 months in the placebo group.
- They noted that pain, disability, patient-perceived rate of recovery and range of movement scores were significantly better in the actively treated group compared with the placebo group at all time intervals. They reported one presycopal episode in the actively treated group but no other significant complications.
The authors concluded, "SSNB is highly effective in reducing the duration of frozen shoulder. It reduces pain significantly and is associated with high levels of patient satisfaction with recovery. It is safe and can be recommended as a useful adjunct therapy".
For further information:
Shanahan E, Briggs E, Gill T, Hill C, Morris T. Suprascapular Nerve Block for the Treatment of Adhesive Capsulitis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 10). https://acrabstracts.org/abstract/suprascapular-nerve-block-for-the-treatment-of-adhesive-capsulitis/.