Efficacy and safety of ultrasound-guided suprascapular nerve block in patients with chronic shoulder pain
Introduction: The painful shoulder syndrome is one of the most common chronic pain conditions of muscle-skeletal origin. It is frequent to find patients who do not improve with conservative treatment based on medications and physical therapy, or even with surgical management. Ultrasound-guided suprascapular blockade is another option when basic therapy does not work.
Objective: To determine the clinical efficacy and safety of interventional management with ultrasound-guided suprascapular nerve block in patients with chronic shoulder pain.
Materials and methods: A descriptive, prospective, follow-up study was conducted in a cohort of 46 patients with chronic shoulder pain disorder who received interventional treatment under ultrasound guidance at the Colombian Pain Institute between October 2011 and May 2012, with the objective of determining efficacy and safety of the procedure. Data were gathered before the procedure, and then two days later and one month after the procedure. Pain intensity was measured using the visual analogue scale (VAS).
Results: Forty-six blocks were performed. Overall, 78.3% of the patients experienced at least 50% reduction of pain two days later, and 47.8% had pain relief after one month, with a statistically significant difference (p < 0.0001) between the starting VAS median score and the median scores on the second postoperative day and at one month. There were no complications.
Conclusions: Ultrasound-guided suprascapular blockade is an effective and safe treatment option in patients with chronic shoulder pain.
2.Philadelphia Panel. Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for shoulder pain. Phys Ther. 2001;81:1719-30.
3.Wertheim HM, Rovenstime FA. Suprascapular nerve block. Anesthesiology. 1941;2:541-5.
4.Allen Zoe A, Michael Shanahan E, Crotty M. Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomised controlled trial with masked outcome assessment. BMC Neurol. 2010;10:83.
5.Yasar E, Vural D, Safaz I, Balaban B, Yilmaz B, Goktepe AS, et al. Which treatment approach is better for hemiplegic shoulder pain in stroke patients: intra-articular steroid or suprascapular nerve block? A randomized controlled trial. Clin Rehabil. 2011;25:60-8.
6.Chan Ch, Peng PWH. Suprascapular nerve block: a narrative review. Reg Anesth Pain Med. 2011;36:4.
7.Harmon D, Hearty C. Ultrasound-guided suprascapular nerve block technique. Pain Phys. 2007;10:743-6.
8.Schultz JS. Clinical evaluation of the shoulder. Phys Med Rehabil Clin N Am. 2004;15:351-71.
9.Esenyel CZ, Ozturk K, Demirhan M, Sonmez M, Kahraman S, Esenyel M, Ozbaydar MU, Senel B. Accuracy of anterior glenohumeral injections: a cadaver study. Arch Orthop Trauma Surg. 2010;130:297-300.
10.Kim JS, Yun JS, Kim JM, Ko YJ, Rhee WI, Ha NK, et al. Accuracy of the glenohumeral injection using the superior approach: a cadaveric study of injection accuracy. Am J Phys Med Rehabil. 2010;89:755-8.
11.Choudur HN, Ellins ML. Ultrasound-guided gadolinium joint injections for magnetic resonance arthrography. J Clin Ultrasound. 2011;39:6-11.
12.Gokalp G, Dusak A, Yazici Z. Efficacy of ultrasonography-guided shoulder MR arthrography using a posterior approach. Skeletal Radiol. 2010;39:575-9.
13.Philip WH, Peter C. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures. Part III: Shoulder. Reg Anesth Pain Med. 2011;36:592-605.
14.Peng P, Narouze S. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy and procedures. Part I: Non-axial structures. Reg Anesth Pain Med. 2009;34:458-74.
15.Chan Ch, Pen PWH. Suprascapular nerve block: a narrative review. Reg Anesth Pain Med. 2011;36:358-73.
16.Shah N, Lewis M. Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections. Br J Gen Pract. 2007;57:662-7.
17.Borglum J, Bartholdy A, Hautopp H, Krogsgaard MR, Jensen K. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review. Acta Anaesthesiol Scand. 2011;55:242-7.
The Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.) is the owner of all copyrights to any articles published in the journal. Published manuscripts become the permanent property of S.C.A.R.E. and may not be published elsewhere without written permission. S.C.A.R.E. keeps the right to use these manuscripts in any form, including print, video, audio and digital.
Creative Commons License
Open-access articles can be read, downloaded and shared on a free basis upon publication. The Journal publishes all articles under the CCBY- NC-ND license. Attribution-NonCommercial-NoDerivs: CC BY- NC-ND. Of the six main licenses, this is the most restrictive because it only allows others to download and share articles as long as they give credit to the author, but they cannot in any way change the paper or use it commercially.