Frozen shoulder: Which is better, Nerve block or steroid injections?

A study aimed at determining the effectiveness of ultrasound-guided supra-scapular nerve block (SSNB) or intra-articular steroid injections (IASI) for pain and disability in adhesive capsulitis (also called frozen shoulder) was published recently in the ‘Pakistan Journal of Medical Sciences’.

This randomized controlled trial by Zeeshan Khan Nazim and researchers involved 72 patients with diffuse shoulder pain. The participants were grouped as:

• Group A: Patients received IASI (2ml of 40 mg/ml Methylprednisolone + 2ml of Lignocaine 1%) and,
• Group B: Patients received ultrasound-guided SSNB

The average age of participants was similar across both groups, with 60.1 years in the IASI group and 58 years in the SSNB group. The SSNB group encountered considerably less pain in the third week and a lower disability index. Compared to IASI, SSNB led to better shoulder external rotation and abduction at one, three, and six weeks.

For the management of adhesive capsulitis, ultrasound-guided supra-scapular nerve block proves to be a more effective pain relief option than intra-articular steroid injections with the benefit of enhancing the mobility of the shoulder.