Improving pain in the patients with adhesive capsulitis by comparing the effect of combined shoulder anterior capsular block and intraarticular steroid injection versus intraarticular steroid injection.
Comparing between combined shoulder anterior capsular block and intraarticular steroid injection versus intraarticular steroid injection for enhancing pain relief in adhesive capsulitis as regards: * To measure analgesic parameters including: assessment of pain score by using Visual Analogue Score during 8 weeks follow up in comparison to baseline and total amount of rescue analgesic (ibuprofen) consumption. * To assess the Shoulder pain and Disability Index * To record complications of the block (local anesthetic toxicity, infection, bleeding, nerve injury) * Over all patient's satisfaction: The patients will be asked to rate the overall degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
patients will receive ultrasound guided (SHAC) block combined with intraarticular steroid injection of the affected shoulder joint followed by home exercise program.
patients will receive intraarticular steroid injection of the affected shoulder joint followed by home exercise program
Faculity of Medicine, Zagazig University
Zagazig, Egypt
RECRUITINGpain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Time frame: BEFORE STARTING PROCEDURE (0 hour)(baseline)
pain intensity
measured by Visual Analogue Scale(VAS) as 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Time frame: 15 minutes after the procedure
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Time frame: first 6 hours postoperative
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Time frame: one week after procedure
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Time frame: 3 weeks after procedure
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Time frame: 6 weeks after procedure
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Time frame: 8 weeks after procedure
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Assessment of Shoulder Pain and Disability Index (SPADI)
SPADI contains 13 items that assess two domains - a five item subscale that measures pain and an eight item subscale that measures disability. Each subscale scored 10 ranging from 0 (best) to 10 (worst). It is a self administered, valid questionnaire,
Time frame: baseline (0 ) and subsequently at one week, 3 weeks , 6 weeks and 8 weeks after procedure
Total amount of rescue analgesia
Total amount of rescue analgesia (ibuprofen)
Time frame: first 24 hours
patient's satisfaction
degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia)
Time frame: 1 week after procedure
Complications of SHAC block
Complications of SHAC block (local anesthetic toxicity, infection, bleeding)
Time frame: 24 hours
PASSIVE AND ACTIVE RANGE OF MOTION
Passive and active shoulder flexion, abduction, and external rotation will be measured using goniometer
Time frame: at baseline, first week and third week follow up post intervention.