Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > European Journal of Physical and Rehabilitation Medicine 2022 August;58(4) > European Journal of Physical and Rehabilitation Medicine 2022 August;58(4):630-7

CURRENT ISSUE
 

JOURNAL TOOLS

Publishing options
eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

ORIGINAL ARTICLE   Free accessfree

European Journal of Physical and Rehabilitation Medicine 2022 August;58(4):630-7

DOI: 10.23736/S1973-9087.22.07410-X

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Randomized controlled trial of suprascapular nerve blocks for subacute adhesive capsulitis

Marc SCHILTZ 1, 2 , Nele BEECKMANS 3, Bruno GILLARD 2, Tom DE BAERE 4, Samar M. HATEM 1, 5, 6

1 Department of Physical and Rehabilitation Medicine, UZ Brussel, Brussels, Belgium; 2 Department of Physical and Rehabilitation Medicine, Clinique St-Jean, Brussels, Belgium; 3 Department of Physical Medicine and Rehabilitation, Regional Hospital RZ Tienen, Tienen, Belgium; 4 Department of Orthopedic Surgery, CHIREC Hospital, Brussels, Belgium; 5 Department of Physical and Rehabilitation Medicine, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; 6 STIMULUS Consortium, Vrije Universiteit Brussel, Brussels, Belgium



BACKGROUND: Shoulder pain and loss of function remain a therapeutic challenge in adhesive capsulitis. Suprascapular nerve blocks, a common treatment in adhesive capsulitis, are considered a safe and effective method for the resolution of pain and restoration of shoulder range of motion (ROM). To our knowledge, no data are available on the use of suprascapular nerve blocks in adhesive capsulitis in the subacute phase.
AIM: The aim of this study was to compare the efficacy of ultrasound-guided suprascapular nerve blocks versus saline injections for treating adhesive capsulitis in the subacute phase.
DESIGN: Randomized double-blinded controlled trial; level of evidence 2.
SETTING: Out-patient consultation of Physical and Rehabilitation Medicine in a general hospital.
POPULATION: Thirty-five patients with subacute adhesive capsulitis.
METHODS: Patients were randomly allocated to receive either 3 successive (1-week interval) ultrasound-guided suprascapular nerve blocks with ropivacaine 5 mL 2 mg/mL (intervention group) or ultrasound-guided injections of 5 mL sterile saline solution (NaCl 0.9%) (control group), at the floor of the suprascapular fossa. Primary outcome was shoulder function assessed by the Constant-Murley Score. Secondary outcomes were shoulder ROM and shoulder pain intensity. Assessments were performed before each injection and 4 weeks after the last injection.
RESULTS: A significant increase of Constant-Murley Score (P<0.001), increase of shoulder ROM (all directions: P<0.011) and decrease of pain (P<0.001), were observed over time in both study groups. However, no significant differences were observed between the intervention and the control group.
CONCLUSIONS: Three successive suprascapular nerve blocks did not provide a better outcome than saline injections on shoulder function, ROM, and pain in subacute adhesive capsulitis. These negative findings warrant some considerations on the natural history of adhesive capsulitis, as well as timing, type, and placebo effects of injections.
CLINICAL REHABILITATION IMPACT: The current place of suprascapular nerve blocks in the treatment strategy of adhesive capsulitis needs to be rediscussed.


KEY WORDS: Bursitis; Shoulder; Nerve block; Placebos; Ropivacaine; Saline solution

top of page