A Comparative Study on Efficacy of Suprascapular Nerve Block vs Subacromial Steroid Injection in Shoulder Impingement Syndrome

Abstract

Background: Shoulder impingement syndrome is one of the most common musculoskeletal pathologies leading to PM and R Outpatient Department visit. Over decades of use, literature shows lower infiltraton and effficacy of intra-shoulder joint steroid in some etological subtypes of impingement syndrome. Interestngly, interventon at suprascapular nerve, the major aferent supply around shoulder, has emerged as a treatment opton for painful shoulder rehabilitaton. This study is a sincere atempt to look for the effficacy of suprascapular nerve block (SSNB) over subacromial cortcosteroid injecton in shoulder impingement syndrome. Objective(s): 1. To look for improvement in Visual Analog Scale (VAS) and Shoulder Pain and Disability Index (SPADI) afer SSNB or subacromial steroid injecton in shoulder 2. To compare the effficacy of both the approaches. Method(s): This was a randomized controlled trial conducted on a total of seventy patients, 35 in each group, for 18 months at the Department of PM and R, IPGMER and SSKM Hospital, Kolkata, West Bengal, India. Inclusion criteria: Conservatve treatment failure Ultrasonography showing Neer Stage I and II impingement VAS >5. Exclusion criteria: Coagulopathy Rotator cuf tear History of IACS within the last 3 months. Afer Ethics Commitee clearance, CTRI registraton, and obtaining informed consent, two groups were made randomly. Group A received steroid injecton by subacromial approach [Figure 1] and SSNB was done in Group B. All patients were included in step-wise rehabilitaton program. Assessment by VAS and SPADI was done at baseline and 2/4/12 weeks afer injecton. Result(s): Statstcally significant improvement was seen in both groups with beter result in SSNB. Intergroup comparison of SPADI was done by Student's unpaired t-test Conclusion(s): SSNB is a beter alternatve both in short term and long term to subacromial steroid injecton in the management of shoulder impingement syndrome.