Jung TW, Lee SY, Min SK, Lee SM, Yoo JC. Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up.
Orthop J Sports Med 2019;
7:2325967119859277. [PMID:
31384617 PMCID:
PMC6651672 DOI:
10.1177/2325967119859277]
[Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND
No therapeutic intervention is universally accepted as the most effective treatment for adhesive capsulitis. An intra-articular corticosteroid injection (IAI) with a suprascapular nerve block (SSNB), a common treatment for this disease, is a safe and effective method for the resolution of pain and restoration of shoulder range of motion (ROM).
PURPOSE
To compare the efficacy of combined SSNB and IAI with that of IAI alone in the treatment of adhesive capsulitis.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
We performed a retrospective review of 102 patients with adhesive capsulitis who were treated at an outpatient clinic from July 2016 to January 2017. A combined SSNB with IAI was performed in 48 patients (SSNB + IAI group), and an IAI alone was performed in 54 patients (IAI group). Patients were assessed before the intervention and at 2 weeks and 2 months after the intervention. ROM and pain and function visual analog scales (PVAS and FVAS, respectively), the American Shoulder and Elbow Surgeons (ASES) score, the Korean Shoulder Scoring System (KSS), the Constant score, the Simple Shoulder Test (SST), and the Shoulder Pain and Disability Index (SPADI) were used for clinical assessments. PVAS, FVAS, and ASES scores at a minimum of 1 year after the intervention were assessed for 82 patients.
RESULTS
At the 2-month assessment, all parameters significantly improved in both the SSNB + IAI and IAI groups (P < .05), however, improvements in forward flexion (FF) and abduction (ABD) between the 2-week and 2-month assessments were better in the SSNB + IAI group. At the 2-month assessment, improvements in the FVAS, ASES, SST, and SPADI scores and FF and ABD values were statistically significantly greater in the SSNB + IAI group compared with the IAI group. Improvements in FVAS and ASES scores were significantly greater in the SSNB + IAI group at a minimum of 1 year.
CONCLUSION
Both a combined SSNB and IAI and an IAI alone significantly improved pain and functional outcomes in patients with adhesive capsulitis. The use of an SSNB with an IAI further increased treatment efficacy, as per the FVAS, ASES, SST, and SPADI scores and FF and ABD values. Patients who underwent SSNB combined with an IAI showed better improvements in the FVAS and ASES scores compared with IAI alone at a minimum of 1 year after the intervention. Therefore, an SSNB combined with an IAI may be a good treatment choice for adhesive capsulitis.
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