Suprascapular Nerve Block Added to Steroid Injection Shows Early Pain Benefit in Adhesive Capsulitis
This randomized clinical trial enrolled 96 patients with adhesive capsulitis to compare three interventions: intra-articular steroid (IAS) injection plus suprascapular nerve block (SSNB), IAS injection alone, and physical therapy (PT) as a control. The primary outcome was improvement in Shoulder Pain and Disability Index (SPADI) scores at 12 weeks post-intervention, with secondary assessments including VAS pain, QuickDASH, Constant-Murley ROM, quality of life (QoL), and medication use (MQS 3) at day 0 and weeks 2, 6, and 12.
At week 2, the IAS+SSNB group showed a statistically significant improvement in SPADI scores over the IAS-only group (33.6±8.0 vs 38.3±8.9, p=0.04). A notable decrease in VAS pain was also observed in the immediate post-intervention period for the combination group. SPADI, VAS, QuickDASH, and Constant-Murley ROM scores showed significant reduction or improvement from baseline through week 12 in both the IAS and IAS+SSNB groups (p<0.05). MQS 3 scores decreased significantly up to week 6 in both groups. However, no significant changes in QoL were observed among the groups (p>0.05).
Critically, the study found no clinically significant difference in outcomes between the IAS+SSNB and IAS-only groups by week 12, except for the immediate VAS decrease. Safety and tolerability data, including adverse events and discontinuations, were not reported. Key limitations, such as sample size justification, blinding procedures, and specific PT protocol details, were not described in the provided data, which tempers the strength of the conclusions.
For practice, this evidence indicates that adding an SSNB to a standard IAS injection may provide a short-term analgesic advantage in the first few weeks, particularly for immediate post-procedure pain. However, it does not appear to confer a clinically meaningful benefit on the 12-week functional outcome trajectory for adhesive capsulitis. The absence of reported safety data necessitates caution.
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