Comparing The Clinical Efficacy Of Intra Articular Shoulder Injection Verses Combined Suprascapular And Axillary Nerve Block For Adhesive Capsulitis
Original Article
DOI:
https://doi.org/10.69830/jbkmc.v5i02.150Keywords:
Adhesive Capsulitis, Frozen shoulder, Suprascapular Nerve Block, Axillary Nerve Block, Intra- Articular Corticosteroid Injection, TreatmentAbstract
Objective: To evaluate the effectiveness of combined suprascapular nerve block with axillary nerve block and intra-articular steroid injection for the treatment of adhesive capsulitis.
Study Design: Cross sectional study
Place and Duration of the Study: Outpatient Department of Anesthesia & Pain Medicine, Ghurki Trust Teaching Hospital, Lahore, Pakistan
Methodology: Patients in Group A were subjected to Ultrasound (USG) guided Selective Sensory Nerve Block (SSNB) in conjunction with Axillary Nerve Block (ANB), while patients in Group B received Intra- Articular (IA) methylprednisolone. Evaluations were conducted at baseline and at the 2nd, 4th, 6th, 8th, and 12th weeks post-intervention, utilizing the Visual Analog Scale (VAS), active and passive Range of Motion (ROM) of the shoulder, and the Shoulder Pain and Disability Index (SPADI). Statistical significance was assessed using Chi-square for qualitative variables and unpaired or paired t-tests for quantitative data. A p- value of less than 0.05 was considered indicative of statistical significance.
Results: In this study of 80 participants, Group A showed significantly better outcomes than Group B over 12 weeks. Baseline pain scores were similar (7.50 ± 1.15 in Group A vs. 7.60 ± 1.20 in Group B, p=0.75), but by week 12, Group A's pain reduced to 2.60 ± 1.00 compared to 4.50 ± 1.20 in Group B (p<0.001). Group A also had greater improvements in active and passive range of motion. For example, active abduction increased to 150.0 ± 10.0 degrees in Group A vs. 135.0 ± 11.0 degrees in Group B (p=0.003), and passive abduction to
160.0 ± 15.0 degrees vs. 135.0 ± 16.0 degrees (p<0.0005). Overall, Group A had significantly better improvements in pain and mobility.
Conclusion: The study concludes that IA steroid injection and combined SSNBwith ANB treat AC well. Long-term results are better with SSNB and ANB than steroid injections. Thus, SSNB and ANB can supplement exercise treatment and replace IAS if necessary.
