Suprascapular nerve block for the treatment of hemiplegic shoulder pain in patients with long-term chronic stroke: a pilot study.

Abstract

Hemiplegic shoulder pain is the most common pain condition after stroke. Suprascapular nerve block is an effective treatment for shoulder pain. The aim of this pilot study was to evaluate the effects of suprascapular nerve block on pain intensity, spasticity, shoulder passive range of motion, and quality of life in long-term chronic stroke patients with hemiplegic shoulder pain. Ten chronic stroke patients (over 2 years from onset) with hemiplegic shoulder pain graded ≥30 mm on the Visual Analogue Scale underwent suprascapular nerve block injection with 1 mL of 40 mg/mL methylprednisolone and 10 mL 0.5% bupivacaine hydrochloride. Main outcome was the Visual Analogue Scale evaluated before and after nerve block at 1 h, 1 week, and 1 month. Secondary outcomes were the modified Ashworth scale and the shoulder elevation, abduction, and external rotation passive range of motion evaluated before the nerve block and after 1 h as well as the American Chronic Pain Association Quality of Life Scale evaluated before and after nerve block at 1 month. The Visual Analogue Scale significantly improved after nerve block at 1 h (P = 0.005) and 1 week (P = 0.011). Significant improvements were found at 1 h after nerve block in the modified Ashworth scale (P = 0.014) and the passive range of motion of shoulder abduction (P = 0.026), flexion (P = 0.007), and external rotation (P = 0.017). The American Chronic Pain Association Quality of Life Scale significantly improved at 1 month after nerve block (P = 0.046). Our findings support the use of suprascapular nerve block for treating hemiplegic shoulder pain in long-term chronic stroke patients.

• Authors: Alessandro Picelli, Sara Bonazza, Davide Lobba, Massimo Parolini, Alvise Martini, Elena Chemello, Marialuisa Gandolfi, Enrico Polati, Nicola Smania, Vittorio Schweiger
• Journal: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (Neurol Sci) Vol. 38 Issue 9 Pg. 1697-1701 (Sep 2017) ISSN: 1590-3478 [Electronic] Italy
• PMID: 28699104 (Publication Type: Journal Article)

Chemical References

• Anesthetics, Local
• Glucocorticoids
• Methylprednisolone
• Bupivacaine

Topics

• Aged
• Anesthetics, Local (administration & dosage)
• Bupivacaine (administration & dosage)
• Chronic Disease
• Chronic Pain (etiology, physiopathology, therapy)
• Female
• Functional Laterality
• Glucocorticoids (administration & dosage)
• Hemiplegia (etiology, physiopathology, therapy)
• Humans
• Injections
• Male
• Methylprednisolone (administration & dosage)
• Muscle Spasticity (etiology, physiopathology, therapy)
• Nerve Block
• Pilot Projects
• Quality of Life
• Range of Motion, Articular
• Shoulder Joint (innervation, physiopathology)
• Shoulder Pain (etiology, physiopathology, therapy)
• Stroke (complications, physiopathology, therapy)