Suprascapular Nerve Block in Treatment of Idiopathic Frozen Shoulder

Abstract

Background: frozen shoulder, is an inflammatory condition of the glenohumeral joint that is characterized by
varying degrees of stiffness and pain. The true causes of frozen shoulder are poorly understood and it is
generally regarded as having insidious onset. Much controversy exists regarding the diagnosis and treatment
of frozen shoulder and it remains one of the more complex conditions to treat.
Aim: To assess the effectiveness of suprascapular nerve block using pubivacaine HCL 0.5% AND
methylprednisolone 4o mg to relieve pain and improve range of movement, and its suitability for use in
primary care in the treatment of frozen shoulder in our department .
Method: 24 patients clinically diagnosed as having frozen shoulder were included in our study .Those
Patients received a single suprascapular nerve block by using a modified technique in which we depended on
anatomical landmarks. Shoulder pain and disability index (SPADI) were used as main outcome measure of
pain and disability and to compared this index before and 4 weeks after injection and range of movement
especially abduction and external rotation as the second outcome and to compared this range also before and 4
weeks after injection. During this period the patients were subjected to course of physiotherapy.
Results: The results of this study show a clear benefit from the use of suprascapular nerve block in patients
with frozen shoulder. There were statistically and clinically significant reduction in pain and disability and
significant improve in the range of movement. These result were confirmed by statistical analysis using SPSS
16.0 t-test that (P < 0.01 for pain and disability levels and P < 0.05 for range of abduction and external
rotation)which considered as highly significant.
Conclusions: This study suggests that suprascapular nerve block is a safe, effective and well tolerated
treatment for frozen shoulder can be used in primary care in our department since there was no recorded
complication through the period of our study by using the modified technique.