Comparing Three Modalities of Treatment for Frozen Shoulder: A Prospective, Double-Blinded, Randomized Control Trial.

Abstract

To compare the effects of three modalities of pain management i.e. SSNB (suprascapular nerve block) with NIR (non invasive rehabilitation), IAI (intra articular injection) with NIR and, NIR alone in idiopathic frozen shoulder patients. A double blinded randomized clinical trial was conducted. 60 cases of idiopathic frozen shoulder were selected and randomly divided into three treatment groups; group 1: NIR, group 2: NIR + SSNB, group 3: NIR +IAI. Range of motion, pain score and disability (SPADI: shoulder pain and disability index) score were evaluated pre-treatment and at 12weeks follow up. All three groups were homogenous and comparable regarding their age, sex ratio, pretreatment pain score, disability score and range of motion. There was significant improvement (p < 0.05) post treatment in all three groups with respect to pain score, disability score and range of motion. SSNB with NIR group patients demonstrated better improvement in all parameters examined, which was statistically significant in pain score, disability score and internal rotation but was statistically equivalent for total range of motion and external rotation as compared to shoulder injection group. SSNB in combination with non invasive rehabilitation is an effective and safe mode of treatment for idiopathic frozen shoulder. Present study also proves that SSNB with NIR is a more effective mode of treatment for idiopathic frozen shoulder as compared to NIR alone or in combination with IAI.Level of evidence: Level 1.