Frozen Shoulder
Conditions
Brief summary
he study will include 50 patients with frozen shoulder with no healthy volunteer , Patients in this study will be randomized into two groups suprascapular nerve block and Shoulder anterior capsular block
Detailed description
The study will include 50 patients with frozen shoulder with no healthy volunteer , Patients in this study will be randomized into two groups according to the treatment performed . Shoulder anterior capsular block group Description: Ultrasound guided injection For the SHAC block, with the patient in a beach-chair position and with the arm in extension, the subscapularis muscle is stretched posteriorly and becomes easily visible. With external rotation and abduction, the coracobrachialis and the biceps brachii muscles are displaced, allowing the visualization of the interfascial space between the deep lamina of the deltoid muscle fascia and the superficial lamina of the subscapularis fascia.Once the injection into the fascial space is achieved, the investigators can proceed towards the glenohumeral pericapsular space by crossing the subscapularis muscle with the needle. By injecting the pericapsular space, the investigators reach the terminal articular branches indistinctly from their origin. Furthermore, through the Weitbrecht foramen, a natural capsular foramen between the upper and middle glenohumeral ligaments, we also reach the intra-articular space . Suprascapular nerve block group Description: Patients will be placed in lateral position by using A high - frequency linear ultrasound probe will be placed approximately 2 cm medial to the medial border of the acromion and about 2 cm cranial to the superior margin of the scapular spine the needle will be inserted .The tip of the needle will be placed at the floor of the supraspinatus fossa where the nerve has passed * A volume of (10ml) of 2% lidocaine (2ml), 3% Mepivacaine (2ml) , 1 ml methyl-prednisolone acetate (40 mg) and dextrose 5% (5ml) will be injected to both groups. * All patients in both groups will receive immediate stretching exercises and post injection 3 times weekly followed by home exercises
Interventions
PROCEDUREsuprascapular nerve block group
A volume of (10 ml) of 2% lidocaine (7ml), 3% Mepivacaine (2ml), 1 ml methyl-prednisolone acetate (40 mg) will be injected to both groups.
PROCEDUREshoulder anterior capsular block group
A volume of (10ml) of 2% lidocaine (7ml), 3% Mepivacaine (2ml), 1 ml methyl-prednisolone acetate (40mg) will be injected to both groups.
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
patients will not be aware about which type of intervention they will recieve also the care provider and outcome assessor will be not aware about type of intervention patients will recieve
Intervention model description
The study will include 50 patients with frozen shoulder with no healthy volunteer, Patients in this study will be randomized into two groups according to the treatment performed Shoulder anterior capsular block group and Suprascapular nerve block group
Eligibility
Sex/Gender
ALL
Age
19 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age above 18 years. * Both sexes, males and females. * History of complaint \>6 weeks * Restricted shoulder movement unilaterally in at least 2 planes including abduction, external rotation, and internal rotation and restricted passive movement.
Exclusion criteria
* Patient refusal. * -Allergy to local anaesthetics. * -Infection at the site of injection . * -Coagulopathy * -Prolonged opioid medication * -Pregnancy * -Acute trauma, fracture of the shoulder * People who had received an intra-articular shoulder injection within the last 6 months. * Patients with tendon tear
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain (Visual analogue scale) | at baseline and post-procedure at 1, 3 and 6 months. | s a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between no pain and worst pain. |
| total pain scores | at baseline and post-procedure at 1, 3 and 6 months. | is a combination of simple pain score, radiation, and sleep disturbance score |
| shoulder pain disability index | at baseline and post-procedure at 1, 3 and 6 months. | The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that consists of two dimensions, one for pain and the other for functional activities. The pain dimension consists of five questions regarding the severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various activities of daily living that require upper-extremity use. The SPADI takes 5 to 10 minutes for a patient to complete and is the only reliable and valid region-specific measure for the shoulder. |
| active range of movement of the shoulder joint | at baseline and post-procedure at 1, 3 and 6 months. | The active and passive range of abduction, adduction, flexion , extension , internal rotation and external rotation will be measured using goniometry |
Countries
Egypt
Contacts
Primary ContactHanan Sayed Mohamed AboZaid, Professor
Outcome results
None listed