COMPARISON OF SINGLE SHOT SUPRA SCAPULAR NERVE BLOCK AND INTRA-ARTICULAR STEROID INJECTION IN ADDITION TO PHYSICAL THERAPY FOR THE MANAGEMENT OF FROZEN SHOULDER PATIENTS PRESENTING TO DHQ HOSPITAL RAWALPINDI; A RANDOMIZED CONTROL TRIAL
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Abstract
Background: A frozen shoulder is a condition characterized by pain and limitation of movement in the shoulder joint. Physical therapy is one form of treatment that can be used but combining it with a suprascapular nerve block or steroid injection can speed up recovery. This study compares the effectiveness of these two treatments for the condition.
Methods: A double-blinded randomized control trial was run for 12 months at DHQ Teaching Hospital Rawalpindi, Pakistan compared the effectiveness of SSNB and IAS for frozen shoulder in 40 patients, with 20 in each group. Patients were advised physiotherapy afterward. Moreover, pain and disability scores were calculated by SPADI at 2,4,8 and 12 weeks after administering the respective therapy.
Results: Pain score in the SSNB group improved from 28.45 to 11.65 at 12-week intervals against an improvement from 29.2 to 16.85 in the IAS group. Moreover, the disability score improved from 40.35 to 14.6 at 12 weeks in the SSNB group against an improvement from 41.55 to 21.85 in the IAS group. Compared to the IAS group, the SSNB group had a lower mean of pain and disability scores at weeks 2,4,8 and 12 (p<0.05). Age and gender showed no significant correlations (p>0.05).
Conclusion: Suprascapular nerve block in conjunct with physiotherapy is more effective than intra-articular steroid injection for pain and disability in frozen shoulder, regardless of age and gender. Long-term effectiveness remains to be studied.
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Ayesha Mansoor
Assistant Professor Anesthesia Department DHQ Hospital Rawalpindi - Pakistan
Yasmeen Azeem
Senior Registrar Anesthesia Department Holy Family Hospital Rawalpindi - Pakistan
Basil Usman
House Officer Anesthesia Department DHQ Hospital Rawalpindi - Pakistan
Faizan Shehzad
House Officer Rawalpindi Medical University Rawalpindi - Pakistan
Nimra Iqbal
Post Graduate Trainee Anesthesia Department DHQ Hospital Rawalpindi - Pakistan
Shahzad Anjum
Senior Registrar Department of Orthopedic Surgery DHQ Rawalpindi - Pakistan
Jawad Zahir
Professor Anesthesia Department Holy Family hospital Rawalpindi - Pakistan