Background/Purpose:

Shoulder pain is a significant complication of hemiplegic stroke in at least 25% of cases. The evidence base for the treatment of hemiplegic shoulder pain is poor.  Suprascapular nerve block has been shown to be safe and effective in the treatment of shoulder pain associated with rheumatoid arthritis and degenerative shoulder conditions but its usefulness in a stroke population is unknown.

Methods: We undertook a randomised controlled trial assessing the effectiveness of suprascapular nerve block compared with placebo in a population of stroke patients with hemiplegic shoulder pain. The primary outcome was pain severity measured on a vertical visual analogue scale (VAS), and secondary outcomes are disability (Modified Rankin Scale, Croft Disability Index) and quality of life (EuroQol Health Questionnaire).  All participants were assessed at baseline, and then at 1, 4 and 12 weeks post intervention. Both groups continued to receive routine physiotherapy and standard ward care.

Results:

Patients who received a suprascapular nerve block (SSNB) consistently demonstrated superior and statistically significant pain reduction at all follow up time points.  Mean VAS reduction in the SSNB group was at least 18mm greater when compared to the scores of those who received the placebo injection. The number needed to treat with suprascapular nerve block to reduce one stroke survivor’s pain by 50% at four weeks is 4.  No significant differences were noted between groups in regards to function or quality of life.   No adverse events associated with the intervention were reported.

Conclusion:

Suprascapular nerve block is a safe and effective treatment modality in patients with hemiplegic shoulder pain.

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« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/suprascapular-nerve-block-for-shoulder-pain-in-the-first-year-after-stroke-a-randomised-controlled-trial/