Suprascapular Nerve Block in the Management of Patients Diagnosed With Adhesive Capsulitis
Comparison of the Efficacy of Proximal and Distal Suprascapular Nerve Blocks Under Ultrasound Guidance in the Treatment of Patients Diagnosed With Adhesive Capsulitis
1 other identifier
interventional
70
1 country
1
Brief Summary
This study aims to compare the efficacy of different suprascapular nerve block techniques in patients diagnosed with adhesive capsulitis. Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by pain and restricted range of motion in the shoulder joint, significantly affecting quality of life. The suprascapular nerve provides sensory innervation to the shoulder joint; therefore, nerve blockade is frequently used to alleviate pain. However, there are limited studies evaluating the difference in efficacy between proximal and distal suprascapular nerve blocks. In this research, two different blockade techniques-at the suprascapular notch and the spinoglenoid notch-will be compared in patients diagnosed with adhesive capsulitis at Istanbul University-Cerrahpaşa between 2024 and 2026. The hypothesis of the study is that the block performed at the spinoglenoid notch provides pain relief comparable to the suprascapular notch block while resulting in less motor blockade. Patients participating in the study will be randomly assigned to two groups. Both groups will receive an intra-articular corticosteroid injection into the shoulder joint, along with cold application, Codman exercises, and standard medical therapy. Pre- and post-treatment evaluations will include pain severity (NRS), shoulder function (Modified Constant Score), muscle strength, and range of motion. The results will reveal which technique provides better improvement in shoulder external rotator and abductor muscle strength, shoulder function, and pain relief, thereby offering valuable insights to guide treatment approaches.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Feb 2025
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
February 26, 2025
CompletedFirst Submitted
Initial submission to the registry
July 25, 2025
CompletedFirst Posted
Study publicly available on registry
July 31, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 26, 2026
ExpectedStudy Completion
Last participant's last visit for all outcomes
August 26, 2026
July 31, 2025
July 1, 2025
1.4 years
July 25, 2025
July 25, 2025
Conditions
Outcome Measures
Primary Outcomes (3)
Evaluation of the Strength of Shoulder External Rotation and Abduction.
Shoulder external rotation strength will be assessed in two different positions: with the arm at the side of the body and with the shoulder in 90 degrees of abduction. Additionally, shoulder abduction strength will be evaluated in two positions: with the shoulder in 90 degrees of abduction and in 90 degrees of abduction combined with 30 degrees of horizontal adduction.
Patients will be assessed at baseline (pre-procedure), 1 week, and 1 month following the glenohumeral joint injection and suprascapular nerve block
Pain Relief
Pain will be assessed using the Numerical Rating Scale (NRS), which ranges from 0 (no pain) to 10 (worst pain imaginable), at rest, during movement, at night, and overall, both before and after injections into the glenohumeral joint and suprascapular nerve block. Higher scores indicate worse pain outcomes.
Patients will be evaluated before the glenohumeral joint injection and suprascapular nerve block, as well as 1 hour, 1 week, and 1 month after the procedure.
Passive and Active Range of Motion of Shoulder
The shoulder joint's active and passive range of motion will be measured with a goniometer
Patients will be assessed at baseline (pre-procedure), and at 1 hour, 1 week, and 1 month following the glenohumeral joint injection and suprascapular nerve block.
Secondary Outcomes (3)
The Numeric Rating Scale (NRS)
Assessments were performed before, 1 hour after, 1 week after, and 1 month after the glenohumeral joint injection and suprascapular nerve block.
Modified Constant Murley Score
Assessments were performed before, 1 week after, and 1 month after the glenohumeral joint injection and suprascapular nerve block.
Shoulder Disability Questionnaire
Assessments were performed before, 1 week after, and 1 month after the glenohumeral joint injection and suprascapular nerve block.
Study Arms (2)
Patients Receiving Suprascapular Nerve Block at the Suprascapular Notch
ACTIVE COMPARATORPatients Receiving Suprascapular Nerve Block at the Spinoglenoid Notch
ACTIVE COMPARATORInterventions
An intra-articular injection into the glenohumeral joint will be performed using 4 cc of normal saline and 1 cc of betamethasone. Additionally, a suprascapular nerve block will be administered with 5 cc of lidocaine(%2).
Eligibility Criteria
You may qualify if:
- Patients who have had shoulder pain, restricted range of motion (ROM), and night pain for at least 4 weeks
You may not qualify if:
- Age younger than 35 years or older than 75 years.
- Known allergy to the agents used for injection.
- History of trauma and/or surgery involving the same shoulder.
- Presence of uncontrolled diabetes mellitus and/or hypertension.
- Presence of severe chronic respiratory disease.
- Presence of severe heart failure.
- Administration of intra- or peri-articular steroid injection to the affected shoulder within the past 2 months.
- Radiographic evidence of calcific tendinitis, glenohumeral osteoarthritis, acromioclavicular joint osteoarthritis, or bone fracture.
- Full-thickness rotator cuff tear detected by shoulder ultrasonography.
- History of surgical intervention or recent/past fracture in the ipsilateral upper extremity.
- Presence of complex regional pain syndrome or vascular disease in the ipsilateral extremity.
- Known coagulation disorders.
- Cervical disc pathology causing radiculopathy.
- Presence of inflammatory or malignant diseases.
- History of cerebrovascular disease.
- +2 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Istanbul University - Cerrahpasa
Istanbul, Turkey (Türkiye)
Related Publications (24)
Berghs BM, Sole-Molins X, Bunker TD. Arthroscopic release of adhesive capsulitis. J Shoulder Elbow Surg. 2004 Mar-Apr;13(2):180-5. doi: 10.1016/j.jse.2003.12.004.
PMID: 14997096BACKGROUNDWang JP, Huang TF, Hung SC, Ma HL, Wu JG, Chen TH. Comparison of idiopathic, post-trauma and post-surgery frozen shoulder after manipulation under anesthesia. Int Orthop. 2007 Jun;31(3):333-7. doi: 10.1007/s00264-006-0195-7. Epub 2006 Aug 23.
PMID: 16927088BACKGROUNDHamdan TA, Al-Essa KA. Manipulation under anaesthesia for the treatment of frozen shoulder. Int Orthop. 2003;27(2):107-9. doi: 10.1007/s00264-002-0397-6. Epub 2002 Sep 13.
PMID: 12700935BACKGROUNDBae KH, Park KC, Jeong GM, Lim TK. Proximal vs Distal Approach of Ultrasound-guided Suprascapular Nerve Block for Patients With Adhesive Capsulitis of the Shoulder: Prospective Randomized Controlled Trial. Arch Phys Med Rehabil. 2021 May;102(5):819-827. doi: 10.1016/j.apmr.2020.11.003. Epub 2020 Dec 1.
PMID: 33275962BACKGROUNDYildizhan R, Cuce I, Veziroglu E, Calis M. Comparison of Spinoglenoid Versus Suprascapular Notch Approaches for Ultrasound-Guided Distal Suprascapular Nerve Blocks for Shoulder Pain: A Prospective Randomized Trial. Pain Physician. 2024 Jan;27(1):11-19.
PMID: 38285026BACKGROUNDBuchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2008 Jan 23;2008(1):CD007005. doi: 10.1002/14651858.CD007005.
PMID: 18254123BACKGROUNDShanahan EM, Gill TK, Briggs E, Hill CL, Bain G, Morris T. Suprascapular nerve block for the treatment of adhesive capsulitis: a randomised double-blind placebo-controlled trial. RMD Open. 2022 Nov;8(2):e002648. doi: 10.1136/rmdopen-2022-002648.
PMID: 36418088BACKGROUNDJump CM, Waghmare A, Mati W, Malik RA, Charalambous CP. The Impact of Suprascapular Nerve Interventions in Patients with Frozen Shoulder: A Systematic Review and Meta-Analysis. JBJS Rev. 2021 Dec 22;9(12). doi: 10.2106/JBJS.RVW.21.00042.
PMID: 34936584BACKGROUNDZadro J, Rischin A, Johnston RV, Buchbinder R. Image-guided glucocorticoid injection versus injection without image guidance for shoulder pain. Cochrane Database Syst Rev. 2021 Aug 26;8(8):CD009147. doi: 10.1002/14651858.CD009147.pub3.
PMID: 34435661BACKGROUNDLorbach O, Anagnostakos K, Scherf C, Seil R, Kohn D, Pape D. Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections. J Shoulder Elbow Surg. 2010 Mar;19(2):172-9. doi: 10.1016/j.jse.2009.06.013. Epub 2009 Oct 1.
PMID: 19800262BACKGROUNDBuchbinder R, Hoving JL, Green S, Hall S, Forbes A, Nash P. Short course prednisolone for adhesive capsulitis (frozen shoulder or stiff painful shoulder): a randomised, double blind, placebo controlled trial. Ann Rheum Dis. 2004 Nov;63(11):1460-9. doi: 10.1136/ard.2003.018218.
PMID: 15479896BACKGROUNDBuchbinder R, Green S, Youd JM, Johnston RV. Oral steroids for adhesive capsulitis. Cochrane Database Syst Rev. 2006 Oct 18;2006(4):CD006189. doi: 10.1002/14651858.CD006189.
PMID: 17054278BACKGROUNDDiercks RL, Stevens M. Gentle thawing of the frozen shoulder: a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years. J Shoulder Elbow Surg. 2004 Sep-Oct;13(5):499-502. doi: 10.1016/j.jse.2004.03.002.
PMID: 15383804BACKGROUNDPage MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, Buchbinder R. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2014 Aug 26;2014(8):CD011275. doi: 10.1002/14651858.CD011275.
PMID: 25157702BACKGROUNDRyu KN, Lee SW, Rhee YG, Lim JH. Adhesive capsulitis of the shoulder joint: usefulness of dynamic sonography. J Ultrasound Med. 1993 Aug;12(8):445-9. doi: 10.7863/jum.1993.12.8.445.
PMID: 8411327BACKGROUNDWhelton C, Peach CA. Review of diabetic frozen shoulder. Eur J Orthop Surg Traumatol. 2018 Apr;28(3):363-371. doi: 10.1007/s00590-017-2068-8. Epub 2017 Nov 1.
PMID: 29094212BACKGROUNDJuel NG, Brox JI, Brunborg C, Holte KB, Berg TJ. Very High Prevalence of Frozen Shoulder in Patients With Type 1 Diabetes of >/=45 Years' Duration: The Dialong Shoulder Study. Arch Phys Med Rehabil. 2017 Aug;98(8):1551-1559. doi: 10.1016/j.apmr.2017.01.020. Epub 2017 Feb 17.
PMID: 28219686BACKGROUNDShaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am. 1992 Jun;74(5):738-46.
PMID: 1624489BACKGROUNDHand C, Clipsham K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg. 2008 Mar-Apr;17(2):231-6. doi: 10.1016/j.jse.2007.05.009. Epub 2007 Nov 12.
PMID: 17993282BACKGROUNDHazleman BL. The painful stiff shoulder. Rheumatol Phys Med. 1972 Nov;11(8):413-21. doi: 10.1093/rheumatology/11.8.413. No abstract available.
PMID: 4646489BACKGROUNDGrey RG. The natural history of "idiopathic" frozen shoulder. J Bone Joint Surg Am. 1978 Jun;60(4):564. No abstract available.
PMID: 670287BACKGROUNDZreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J. 2016 May 19;6(1):26-34. doi: 10.11138/mltj/2016.6.1.026. eCollection 2016 Jan-Mar.
PMID: 27331029BACKGROUNDReeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol. 1975;4(4):193-6. doi: 10.3109/03009747509165255.
PMID: 1198072BACKGROUNDMoren-Hybbinette I, Moritz U, Schersten B. The clinical picture of the painful diabetic shoulder--natural history, social consequences and analysis of concomitant hand syndrome. Acta Med Scand. 1987;221(1):73-82. doi: 10.1111/j.0954-6820.1987.tb01247.x.
PMID: 2436441BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- PARTICIPANT, INVESTIGATOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- medical doctor
Study Record Dates
First Submitted
July 25, 2025
First Posted
July 31, 2025
Study Start
February 26, 2025
Primary Completion (Estimated)
July 26, 2026
Study Completion (Estimated)
August 26, 2026
Last Updated
July 31, 2025
Record last verified: 2025-07
Data Sharing
- IPD Sharing
- Will not share