Continuous suprascapular nerve blockade to potentiate intensive rehabilitation for refractory adhesive shoulder capsulitis: a cohort study

Int Orthop. 2024 Feb;48(2):495-503. doi: 10.1007/s00264-023-05999-0. Epub 2023 Oct 17.

Abstract

Purpose: Evaluating the short- and long-term efficacy of a continuous ten day suprascapular nerve block combined with daily multidisciplinary rehabilitation on shoulder range of motion (ROM), pain, and function in patients with refractory adhesive capsulitis (AC).

Methods: In this retrospective cohort study, patients admitted to a specialized pain clinic for refractory AC for more than 6 months underwent continuous suprascapular nerve blockade for ten days and received 2 hours of physiotherapy and occupational therapy daily. Standardized assessments were performed at baseline, at days three, six, ten, 30, 90, and 180, and included active and passive ROM measurements, the visual analog scale (VAS) for pain and the disabilities of the arm, shoulder and hand (DASH) questionnaire to assess pain, disability, and quality of life. Improvements over time were assessed using ANOVAs.

Results: Thirty-two patients were followed (age: 52 ± 8 years, 25 females, mean symptoms duration of two years). There was a significant improvement in ROM for all amplitudes at day ten (short-term; range: 20-35°, p < 0.001) and at day 180 (long-term; range: 18-47°, p < 0.001). The pain and disability scores significantly reduced by day 180 (mean VAS reduction: 2.6 units, p < 0.001; mean DASH reduction: 9.5 points, p < 0.001).

Conclusion: Continuous SSNB combined with intensive multidisciplinary rehabilitation represents an efficient therapeutic option for patients with chronic AC who did not respond to conventional treatments.

Keywords: Adhesive capsulitis; Anesthesia; Frozen shoulder; Range of motion; Rehabilitation; Suprascapular nerve block.

MeSH terms

  • Adult
  • Bursitis* / therapy
  • Cohort Studies
  • Female
  • Humans
  • Middle Aged
  • Nerve Block*
  • Quality of Life
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Shoulder
  • Shoulder Pain / therapy
  • Treatment Outcome