Adhesive Capsulitis, Frozen Shoulder, Nerve Block
Conditions
Keywords
suprascapular nerve
Brief summary
Patients presenting with subacute, less than 6 months of evolution, adhesive capsulitis are randomly attributed to the control or study group. Both groups receive a series of 3 suprascapular nerve blocks under ultrasound guidance with either 5ml saline or 5ml ropivacaine 2mg/ml ( ref) at 1 week interval. Testing consists of glenohumeral range of motion (ROM) (anterior elevation, lateral elevation, external and internal rotation) measured by goniometer, Constant score and visual analog scale (VAS) pain score. Evaluations are done immediately before and one hour after every suprascapular block and at 4 weeks after the third suprascapular block. All suprascapular nerve blocks are performed by one physician and the evaluations are done by a occupational therapist or MD experienced in glenohumeral function evaluations. All practitioners are blinded to the assigned group. All patients continue their pre-study treatment of physiotherapy and per os pain medication. Patients keep a record of analgesics and NSAID use during the trial. Drop-out rate is measured.
Detailed description
Introduction: Adhesive capsulitis is a painful and debilitating condition affecting adult shoulders. Although relatively rare the condition is more common in diabetic patients and effective pain diminishing treatments without the use of corticosteroids are needed. Methods and Material: Patients presenting with subacute, less than 6 months of evolution, adhesive capsulitis are randomly attributed to the control or study group. Both groups receive a series of 3 successive suprascapular nerve blocks under live ultrasound guidance with either 5ml saline or 5ml ropivacaine 2mg/ml conducted at 1 week interval. Testing consists of glenohumeral ROM (anterior elevation, lateral elevation, external and internal rotation) measured by goniometer, Constant score, VAS pain score. Evaluations are done immediately before and one hour after every suprascapular block and at 4 weeks after the third suprascapular block. All suprascapular blocks are performed by one physician and the evaluations by either a occupational therapist or MD experienced in glenohumeral function evaluations. All practitioners are blinded to the assigned group. All patients continue their physiotherapy, consisting of electrotherapy, range of motion, stretching and strengthening exercises and their per os medication. Patients keep record of analgesics and NSAID use during the trial. Drop-out rate is measured during the entire study protocol.
Interventions
DRUGRopivacaine Monohydrochloride
Suprascapular nerve block under ultrasound control: injection of 5ml Ropivacaine HCL 2mg /ml
Placebo suprascapular nerve block under ultrasound control: injection of 5ml physiological / isotonic saline
Sponsors
University Hospital St Luc, Brussels
Clinique Saint-Jean, Bruxelles
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* subacute adhesive capsulitis: pain evolving for less than 6 months before enrollment
Exclusion criteria
* other conditions involving the shoulder ( rheumatoid or septic arthritis, Hill-Sachs lesions,osteoarthritis of the shoulder, or malignancies in the shoulder region); * neurologic deficits affecting shoulder function in normal daily activities (such as history of stroke, multiple sclerosis, parkinson disease...) * shoulder pain caused by cervical radiculopathy * a history of drug allergy to ropivacaïne * pregnancy or lactation * cognitive impairment with inability to fill out a protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in constant shoulder score | at 0, 1, 2, and 6 weeks | the total constant score ranges from 0 to 100 points, with higher scores indicative of better function. The score is divided into four sections: pain, activity of daily living, ROM and strength |
| change of pain intensity score | at 0,1,2 and 6 weeks | pain intensity measured by visual analog scale (VAS) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change in gleno-humeral joint range of motion (ROM) | at 0,1,2, and 6 weeks | Shoulder flexion, abduction, external rotation and internal rotation measured with goniometer with the patient in standing position |
Countries
Belgium
Outcome results
None listed