Academic literature on the topic 'Chronic Shoulder Pain; Suprascapular Nerve Block; Ultrasound-Guided Suprascapular Nerve Block'

<strong>Background</strong><strong>:</strong>&nbsp;Suprascapular nerve block (SSNB) is an effective method for the treatment of shoulder disorders. The present study was conducted to evaluate and compare the effectiveness of SSNB under ultrasonographic guidance with anatomical landmark-guided (LMG) technique in the treatment of adhesive capsulitis shoulder.&nbsp;<strong>Objectives:&nbsp;</strong>To evaluate and compare the clinical and functional outcomes of ultrasound (US)-guided versus landmark-guided SSNB for the treatment of adhesive capsulitis shoulder.&nbsp;<strong>Study design:&nbsp;</strong>Randomized, prospective analysis.&nbsp;<strong>Setting:&nbsp;</strong>Patients attending Opd and casualty of department of orthopaedics of GMCH.&nbsp;<strong>Materials and Methods:&nbsp;</strong>500 patients with chronic shoulder pain and stiffness were enrolled. The patients were randomly allocated into 2 groups.250 patients received US-guided SSNB with 5 ml of 0.75% ropivacaine and 250 underwent landmark-guided SSNB with same drug . Initial examinations before injection, first week and first and third months post injection were recorded. Visual Analog Scale (VAS) pain intensity levels, shoulder functions based on the Shoulder Pain and Disability Index (SPADI) were evaluated.&nbsp;<strong>Results:</strong>&nbsp;Statistically significant recovery was observed in terms of VAS pain levels, SPADI from the first week after injection in both groups, but no significant difference was observed between the groups.&nbsp;<strong>Discussion:&nbsp;</strong>In our study the techniques of the SSNB, i.e., USG and LMG resulted in decreased pain score, improved range of motion, and decreased SPADI scores after 3 months of administration of block. However, when both the techniques were compared with each other the improvement in pain score and shoulder movement and decrease in SPADI scores were comparable.&nbsp;<strong>Conclusions:</strong>&nbsp;Our results indicate that US-guided SSNB does not potentially offer a significantly greater clinical improvement over landmark-guided SSNB in patients with adhesive capsulitis shoulder. However Further research is required to establish this hypothesis in clinical practice. &nbsp; &nbsp;

Background: In this article, we describe a case report of using real-time, high-resolution ultrasound guidance to facilitate blockade of the suprascapular nerve. We describe a case report and technique for using a portable ultrasound scanner (38 mm broadband (13-6 MHz) linear array transducer (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A..)) to guide suprascapular nerve block. Methods: A 44-year old male patient presented with severe, painful osteoarthritis with adhesive capsulitis of his right shoulder. The ultrasound transducer in a transverse orientation was placed over the scapular spine. Moving the transducer cephalad the suprascapular fossa was identified. While imaging the supraspinatus muscle and the bony fossa underneath, the ultrasound transducer was moved laterally (maintaining a transverse transducer orientation) to locate the suprascapular notch. The suprascapular nerve was seen as a round hyperechoic structure at 4 cm depth beneath the transverse scapular ligament in the scapular notch. The nerve had an approximate diameter of 200 mm. Real-time imaging was used to direct injection in the scapular notch. Ultrasound scanning confirmed local anesthetic spread. Results: The patient’s pain intensity decreased. Shoulder movement and function improved. These improvements were maintained at 12 weeks. Conclusion: Ultrasound guidance does not expose patients and personnel to radiation. It is also less expensive than other imaging modalities. This technique has applications in both acute and chronic pain management. Key words: Technique, visualization, real-time, Ultrasound,nerve, analgesia.

BACKGROUND: Distal suprascapular nerve blocks (SSNB) can be performed at the level of the suprascapular notch (the preferred site) or at the level of the spinoglenoid notch. OBJECTIVES: To compare the efficacy and safety of spinoglenoid versus suprascapular notch approaches for ultrasound (US)-guided distal SSNB in patients with chronic shoulder pain. STUDY DESIGN: Prospective randomized controlled trial. SETTING: Outpatient physical medicine and rehabilitation outpatient clinic of a tertiary center. METHODS: Eighty patients with chronic unilateral shoulder pain were included in this study. Patients were randomized into 2 groups: group 1 (SSNB at the level of the spinoglenoid notch) and group 2 (SSNB at the level of the suprascapular notch). The patients were evaluated for pain according to the Shoulder Pain and Disability Index (SPADI) and a secondary visual analog scale (VAS), as well as for the outcome measures of range of motion (ROM) and pain pressure threshold (PPT) at baseline and at one, 4, and 12 weeks after the injection. RESULTS: Statistically significant improvement was observed in the SPADI and VAS scores and ROM measurements, and the PPT measurements were similar at all post-injection follow-ups in both groups. Changes in outcome measures were similar between the groups, except for some ROM measurements at the post-injection follow-ups. LIMITATIONS: Heterogeneity of shoulder pain etiologies. CONCLUSION: Both distal SSNB approaches significantly improved pain and disability scores in patients with chronic shoulder pain, with no observable differences in the short-to-medium term. SSNB performed at the level of the spinoglenoid notch is therefore not inferior in efficacy and safety to SSNB performed at the level of the suprascapular notch. KEY WORDS: Shoulder pain, suprascapular nerve block, spinoglenoid notch, suprascapular notch, ultrasound

Aim: Pulsed radiofrequency (PRF) therapy has become increasingly popular in the treatment of chronic shoulder pain due to its long duration of action and non-destructive method. The aim of the study was to reveal the effects of PRF therapy of the suprascapular nerve (SSN) under ultrasound guidance (UG) in patients with chronic shoulder pain on both shoulder pain and function.Material and methods: This study included 74 patients diagnosed with at least one of the following: adhesive capsulitis, rotator cuff syndrome and impingement syndrome of shoulder. The PRF therapy of the SSN under UG was performed in those patients with a reduction of 50% or more Visual Analog Scale (VAS) score and those that reported healing in the active range of motion (AROM) in the diagnostic SSN block. The resting, motion and sleeping shoulder pain assessments of the patients were done with VAS score. The shoulder joint function was assessed with the Shoulder Pain and Disability Index (SPADI) questionnaire and the AROM of the joint was measured using a goniometer.Results: In 70 of the 74 patients a 50% or more reduction was found in the VAS score with diagnostic SSN block. After the PRF therapy of the SSN, the 15thday, 1st month, 3rd month, and 6th month follow-up VAS averages, SPADI averages and the flexion, internal rotation, external rotation, and abduction values were statistically significantly lower than the baseline values (p&lt;0.05).Conclusion: This study is the largest series in the literature evaluating the efficacy of PRF therapy of the SSN under UG and has shown that pain canbe controlled quickly, for a long period of time, using ultrasound guided PRF therapy of the SSN in chronic shoulder pain.