Effects of fluoroscopy-guıded intraartıcular injectıon, suprascapular nerve block, and combınatıon therapy ın hemıplegıc shoulder paın: a prospective double-blınd, randomızed clınıcal study.

OBJECTIVE: To investigate the effect and superiority of fluoroscopy-guided intraarticular shoulder injection (IAI), suprascapular nerve block (SSNB), and combination treatment in hemiplegic shoulder pain (HSP).

DESIGN: We included 30 patients diagnosed with HSP. Patients were divided into three groups: IAI, SSNB, and combination treatment. Patients were assessed using a visual analogue scale (VAS) prior to the injection and at hour 1, week 2, and month 2 after the injection, with goniometry at two angles at the moment that pain started and maximum passive range of motion (ROM) of the shoulder and Modified Barthel Index prior to the injection, at week 2 and month 2 after the injection.

RESULTS: Significant decrease in the VAS and increase in shoulder passive ROMs were detected at all follow-ups in groups. In comparison, there was no significant difference in VAS scores. Change in the internal rotation at the moment that pain started was found to be higher in the patients treated with the combined method than the other methods. Change in maximum passive ROMs was similar between treatment groups.

CONCLUSION: IAI, SSNB, and the combination treatments are reliable and effective treatment modalities that provide pain relief and an increase in shoulder passive ROMs in HSP.