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 2years from onset) with hemiplegic shoulder pain graded ≥30mm on the Visual Analogue Scale underwent suprascapular nerve block injection with 1mL of 40mg/mL methylprednisolone and 10mL 0.5% bupivacaine hydrochloride. Main outcome was the Visual Analogue Scale evaluated before and after nerve block at 1h, 1week, and 1month. 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 1h as well as the American Chronic Pain Association Quality of Life Scale evaluated before and after nerve block at 1month. The Visual Analogue Scale significantly improved after nerve block at 1h (P=0.005) and 1week (P=0.011). Significant improvements were found at 1h 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 1month 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.