Abstract

ULTRA-SOUND GUIDED SUPRASCAPULAR NERVE BLOCK IN HEMIPLEGIC SHOULDER PAIN

Author(s): Swapnil Pramod Sonune, Anil Kumar Gaur, Shefali Gupta

BACKGROUND Hemiplegic shoulder pain is associated with reduced functional improvement, a higher incidence of depression, interference with rehabilitation, and an increased length of hospitalisation. Supra- Scapular Nerve Block (SSNB) has shown efficacy in various chronic shoulder pain management but lacks clinical evidence in case of hemiplegic shoulder pain management. MATERIALS AND METHODS A prospective randomised controlled trial was done to look for the efficacy of suprascapular nerve block in hemiplegic shoulder pain which included 60 patients divided in to two groups. Group A received ultra-sound guided suprascapular nerve block and exercise therapy (n=30); Group B received exercise therapy alone (n=30). Pain outcome was measured using Visual Analogue Scale (VAS) at rest and at movement of affected shoulder at 1st week, 4 th week and 12th week. RESULTS The VAS score, both at rest and at movement, improved significantly in group A with p-value 0.000 which was evident at 1st week post injection. The improvement in VAS score at rest is from 4.67 ± 1.42 to 1.53 ± 1.93 and in VAS score at movement is from 7.53 ± 1.50 to 2.37 ± 1.97 in group A. CONCLUSION Therefore, we conclude that SSNB is a safe and effective treatment option for patients with hemiplegic shoulder pain in the first year after stroke. The intervention can be easily performed using ultra-sound guidance in clinical settings, offering a practical and important advancement for shoulder pain management in this patient population.