Fluoroscopy-guided suprascapular and subscapular articular nerve blocks for chronic shoulder pain: A 12-week observational study

Abstract

Introduction

Chronic shoulder pain is a common musculoskeletal complaint. This study evaluates the effectiveness of fluoroscopy-guided suprascapular (SSN) and subscapular (SCN) articular branch blocks in managing chronic shoulder pain. The primary objective was to assess pain relief using a numerical rating scale (NRS) and functional improvement using Shoulder Pain and Disability Index (SPADI) over 12 weeks.

Methods

This prospective, single-arm observational study included 70 adults with chronic shoulder pain (≥3 months) meeting predefined criteria. All patients underwent fluoroscopy-guided SSN and SCN articular branch blocks with bupivacaine (2 ml, 0.5 %) and triamcinolone (0.5 ml, 20 mg) per site. NRS and SPADI were recorded at baseline and biweekly for 12 weeks. Secondary outcomes included range of motion (ROM) improvements and night pain resolution. Statistical analysis involved repeated measures ANOVA for normally distributed data and non-parametric tests for skewed data (p < 0.05 considered significant).

Results

At 12 weeks, 78 % of patients achieved ≥50 % pain reduction. Mean NRS decreased from 7.6 ± 1.1 to 3.9 ± 1.1, while SPADI pain and disability scores improved by 57.1 % and 57.4 %, respectively (p < 0.001). Night pain resolved in all affected patients within two weeks. Repeated measures ANOVA confirmed significant improvements in pain and disability scores (p < 0.001). Mean lateral abduction improved by 29° (95 % CI: 22.8°–35.2°, p < 0.001).

Conclusion

Fluoroscopy-guided SSN and SCN articular branch blocks provide significant pain relief and functional improvement in chronic shoulder pain, offering a potential alternative to intra-articular injections or surgery in select patients.