Efficacy of ultrasound-guided suprascapular nerve block treatment in patients with painful hemiplegic shoulder

Neurol Sci. 2019 May;40(5):985-991. doi: 10.1007/s10072-019-03749-y. Epub 2019 Feb 9.

Abstract

Objective: The aim of this study was to evaluate the efficacy of ultrasound-guided suprascapular block treatment in patients with painful hemiplegic shoulder whose pain was not reduced after conservative treatment.

Design: The patients were those whose hemiplegic shoulder pain was not reduced by standard conservative treatment prior to discharge. The study group (n = 21) included patients who had undergone an ultrasound-guided suprascapular nerve block (SSNB). The control group (n = 21) were patients who had not undergone SSNB. Both groups undertook home exercise programs. All patients were evaluated at 1 week and 1 and 3 months after the discharge. Evaluations included shoulder range of motion (ROM), Visual Analog Scale (VAS) for pain, EQ-5D-3L for quality of life, the Modified Ashworth Scale (MAS), and Brunnstrom staging.

Results: The shoulder ROM significantly increased in the SSNB group at 1-3 months, when compared with the baseline value. The shoulder ROM significantly decreased (p ˂ 0.05) in the control group at 1-3 months, when compared with the baseline value. The pain VAS and EQ-5D-3L scores significantly decreased (p ˂ 0.05) after treatment in the follow-ups at 1 month in the SSNB group. The control group showed no change from the baseline scores (p ˃ 0.05). The MAS scores and Brunnstrom staging did not differ between the two groups.

Conclusion: The ultrasound-guided SSNB is a safe and more effective treatment than conservative treatment for painful hemiplegic shoulder. Further studies are needed to compare ultrasound-guided and non-guided suprascapular blocks as treatments for hemiplegic shoulder pain.

Keywords: Painful hemiplegic shoulder; Suprascapular nerve; Ultrasound-guided suprascapular nerve block.

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Exercise Therapy
  • Female
  • Follow-Up Studies
  • Hemiplegia / diagnostic imaging
  • Hemiplegia / etiology
  • Hemiplegia / therapy*
  • Humans
  • Male
  • Middle Aged
  • Nerve Block* / methods
  • Pain Measurement
  • Peripheral Nerves
  • Prospective Studies
  • Range of Motion, Articular
  • Scapula
  • Shoulder Pain / diagnostic imaging
  • Shoulder Pain / etiology
  • Shoulder Pain / therapy*
  • Stroke / complications
  • Stroke / therapy
  • Treatment Outcome
  • Ultrasonography, Interventional*