Article

OBJECTIVE: To explore the effectiveness of suprascapular nerve block (SSNB) at
different timing after administration compared with physical therapy, placebo,
and intra-articular injections in patients with chronic shoulder pain. DATA SOURCE: Two electronic data sources, PubMed and Scopus, were mainly searched from
the earliest record to September 2015. STUDY SELECTION: Eleven randomized
controlled trials that compared SSNB with physical therapy, placebo, and
intra-articular injections were included, comprising 591 patients. DATA
EXTRACTION: Patient demographics, regimens for SSNB and intra-articular
injections, use of fluoroscopy or ultrasound guidance, conjunction with physical
therapy, methods of randomization, and measurements of functional change and pain
improvement were retrieved. The standardized mean differences (SMDs) of pain
relief and functional improvement were calculated 1, 4, and 12 weeks after
intervention. DATA SYNTHESIS: Regarding pain relief, SSNB provided better pain
relief for 12 weeks compared with physical therapy (SMD=.75; 95% confidence
interval [CI], .35-1.14) and placebo injections (SMD=.70; 95% CI, .40-1.00), but
was not superior to intra-articular injections. Differences in patient
populations and use of pulsed radiofrequency did not cause a significant
variation in therapeutic efficacy, but guidance using ultrasound showed
consistently better effectiveness than guidance using surface landmarks and
fluoroscopy. CONCLUSIONS: This meta-analysis demonstrated the superiority of SSNB
to placebo and physical therapy and a similar efficacy of SSNB compared with
intra-articular injection for treatment of chronic shoulder pain. Ultrasound was
the most preferable guidance tool, and future studies are advised to integrate
physical therapy in order to improve the long-term effectiveness of SSNB.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS