Frozen shoulder: evaluation of intraarticular corticosteroids injection versus suprascapular nerve block “A prospective clinical study”
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 2
Abstract
Introduction: Adhesive capsulitis (frozen shoulder) has an incidence of 3-5% in the general population. This disorder is one of the most common musculoskeletal problem seen in orthopaedics. Aims and objectives 1. The study was designed to assess the effectiveness of suprascapular nerve block (SSNB) and intra articular steroid (IAS) to relieve pain and improve range of motion. 2. To assess which one had better results in terms of simple pain score and SPADI (shoulder pain and disability index) score along with range of movement at shoulder joint. 3. To record any adverse effects and complications. Materials and methods: The study was conducted in department of orthopaedics, S.M.S. Medical college and attached group of hospitals, Jaipur, with due permission from institutional ethical committee and review board after taking informed and written consent from the patient from 1.4.2015 to 1.4.2016 Study design: hospital based, prospective, randomized, comparative study. Sample size: Sample size was calculated to be 23 subjects in each of 2 groups. Inclusion criteria 1. Patients with history of chronic shoulder pain and decreased range of motion (active and passive) of shoulder. 2. Age group 40-70 years. 3. Either sex. 4. Patients with pain and stiffness for atleast 4 weeks. 5. Who have been on conservative management like pain killers, physiotherapy etc. 6. Patients who give consent to participate in study. 7. Diabetic patients whose HbA1c is less than 6.5% and fasting blood sugar levels are less than 126 mg/dl. Exclusion criteria 1. Patients with intrinsic pathologies of the shoulder such as a) rotator cuff tears b) biceps tendinitis c) Calcific tendinosis. d) History of fracture and dislocation. e) Arthritis of glenohumeral or acromioclavicular joint. f) Sympathetic dystrophy. 2. Patients with extrinsic problems such as a) Neuromuscular disorders (Parkinsonism). b) Referred pain from associated conditions- extrusion of a cervical disc with radiculopathy. c) History of previous surgery of affected shoulder. 3. Patients who refuse to participate in study Results: In early follow ups there was significant improvement in abduction in IAS group than SSNB group, but at final follow up almost normal range of motion was achieved in both the groups. The average improvement in abduction in SSNB group was 86.92º and 68.46º in IAS group. Both groups achieved almost normal range of ER movement at final follow up. The average improvement in ER was 25.19º (SSNB- 32.3º & IAS – 18.08º).All groups achieved significant improvement in pain and restriction of movement and achieved almost normal day to day activity at final follow up. Overall good to excellent results were seen in both the groups.
Authors and Affiliations
Dr. Adam Mahendra Teja, Dr. Ramesh Chandra Banshiwal
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