Suprascapular Nerve Block in the Management of Patients Diagnosed With Adhesive Capsulitis

N/AActive Not RecruitingNCT07097571

Istanbul University - Cerrahpasa70 enrolled

Overview

This study aims to compare the efficacy of different suprascapular nerve block techniques in patients diagnosed with adhesive capsulitis. Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by pain and restricted range of motion in the shoulder joint, significantly affecting quality of life. The suprascapular nerve provides sensory innervation to the shoulder joint; therefore, nerve blockade is frequently used to alleviate pain. However, there are limited studies evaluating the difference in efficacy between proximal and distal suprascapular nerve blocks. In this research, two different blockade techniques-at the suprascapular notch and the spinoglenoid notch-will be compared in patients diagnosed with adhesive capsulitis at Istanbul University-Cerrahpaşa between 2024 and 2026. The hypothesis of the study is that the block performed at the spinoglenoid notch provides pain relief comparable to the suprascapular notch block while resulting in less motor blockade. Patients participating in the study will be randomly assigned to two groups. Both groups will receive an intra-articular corticosteroid injection into the shoulder joint, along with cold application, Codman exercises, and standard medical therapy. Pre- and post-treatment evaluations will include pain severity (NRS), shoulder function (Modified Constant Score), muscle strength, and range of motion. The results will reveal which technique provides better improvement in shoulder external rotator and abductor muscle strength, shoulder function, and pain relief, thereby offering valuable insights to guide treatment approaches.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Eligibility

Sex: ALLMin age: 35 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who have had shoulder pain, restricted range of motion (ROM), and night pain for at least 4 weeks Exclusion Criteria: * Age younger than 35 years or older than 75 years. * Known allergy to the agents used for injection. * History of trauma and/or surgery involving the same shoulder. * Presence of uncontrolled diabetes mellitus and/or hypertension. * Presence of severe chronic respiratory disease. * Presence of severe heart failure. * Administration of intra- or peri-articular steroid injection to the affected shoulder within the past 2 months. * Radiographic evidence of calcific tendinitis, glenohumeral osteoarthritis, acromioclavicular joint osteoarthritis, or bone fracture. * Full-thickness rotator cuff tear detected by shoulder ultrasonography. * History of surgical intervention or recent/past fracture in the ipsilateral upper extremity. * Presence of complex regional pain syndrome or vascular disease in the ipsilateral extremity. * Known coagulation disorders. * Cervical disc pathology causing radiculopathy. * Presence of inflammatory or malignant diseases. * History of cerebrovascular disease. * Presence of mental impairment or severe psychiatric disorders. * Pregnancy.

Outcomes

Primary Outcomes

Evaluation of the Strength of Shoulder External Rotation and Abduction.

Shoulder external rotation strength will be assessed in two different positions: with the arm at the side of the body and with the shoulder in 90 degrees of abduction. Additionally, shoulder abduction strength will be evaluated in two positions: with the shoulder in 90 degrees of abduction and in 90 degrees of abduction combined with 30 degrees of horizontal adduction.

Time frame: Patients will be assessed at baseline (pre-procedure), 1 week, and 1 month following the glenohumeral joint injection and suprascapular nerve block

Pain Relief

Pain will be assessed using the Numerical Rating Scale (NRS), which ranges from 0 (no pain) to 10 (worst pain imaginable), at rest, during movement, at night, and overall, both before and after injections into the glenohumeral joint and suprascapular nerve block. Higher scores indicate worse pain outcomes.

Time frame: Patients will be evaluated before the glenohumeral joint injection and suprascapular nerve block, as well as 1 hour, 1 week, and 1 month after the procedure.

Passive and Active Range of Motion of Shoulder

The shoulder joint's active and passive range of motion will be measured with a goniometer

Time frame: Patients will be assessed at baseline (pre-procedure), and at 1 hour, 1 week, and 1 month following the glenohumeral joint injection and suprascapular nerve block.

Secondary Outcomes

The Numeric Rating Scale (NRS)

A pain screening tool, commonly used to assess pain severity at that moment in time using a 0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable

Time frame: Assessments were performed before, 1 hour after, 1 week after, and 1 month after the glenohumeral joint injection and suprascapular nerve block.

Modified Constant Murley Score

Patients will be assessed according to the modified Constant score, focusing on pain, activities of daily living, range of motion, and muscle strength.

Time frame: Assessments were performed before, 1 week after, and 1 month after the glenohumeral joint injection and suprascapular nerve block.

Shoulder Disability Questionnaire

Patients will respond to the items of the Shoulder Disability Questionnaire with reference to the past 24 hours.