Abstract: Introduction: Shoulder joint is very important joint for day to day activities and pain in shoulder results in leads to increased functional disability with poor quality-of life. Chronic shoulder pain common complaints encountered by treating physicians all over world. The incidence of chronic shoulder pain is approximately 15-30% with variations among different population and age groups. The treatment modalities available for alleviating chronic shoulder pain varies from simple anti-inflammatory drugs to interventional procedures like intra-articular steroid injections, supra-scapular nerve block (SSNB).
AIM: To compare the pain relief and return of function in shoulder joint using suprascapular nerve block under ultrasound guidance (lignocaine and methylprednisolone acetate) versus shoulder infiltration (lignocaine and methylprednisolone acetate) in chronic shoulder pain.
Study Design: Prospective, randomised study, data was collected from patients with chronic shoulder pain in the age group of 18-60 years coming to orthopedic outpatient department at Yenepoya Medical College Hospita with chronic shoulder pain.
Materials and Methods: Suprascapular nerve block group: 2ml of 40mg methyl prednisolone +2ml of lignocaine given, supervision of anesthetist under ultrasound guidance. Intra articular steroid group: 2ml of 40mg methyl prednisolone acetate +2ml 2% lignocaine hydrochloride given through posterior approach to shoulder. Eligible participants was randomly assigned to receive the same combination of medications either by supra scapular nerve block under ultrasound guidance or blind shoulder infiltration and compare the effect of lignocaine and corticosteroid in suprascapular nerve block and shoulder infiltration in chronic shoulder pain by assessing DASH score, Constant-Murley score, SPADI score and VAS pain score on day 7 and day 28 of the procedure.
Results: There were no significant differences between the groups in terms of pain, demographic variables, Range of movement and disability scores when compared to baseline. (p >0.05). However suprascapular nerve block showed slight better improvement in pain, range of movement and disability score at initial (i.e. at 1week) and at 4 week follow up when compared with that of intra-articular steroid infiltration but scores were not statistically significant. Parameters obtained in both groups were significant at final assessments when compared to the baseline scores.
Conclusion: Suprascapular nerve block can be considered as a safe, effective, well tolerated treatment and alternative line of treatment in patient suffering from chronic shoulder pain.
