Comparative efficacy of supra-scapular nerve block, posterior shoulder capsule hydro-dilatation, and shoulder interval hydro-dilatation in managing shoulder adhesive capsulitis.

Aim of work: This study aimed to compare the effects of supra-scapular nerve block, posterior intra-articular hydro-dilatation, and hydro-dilatation of the shoulder interval, in terms of improving pain, function, and range of motion in patients with adhesive capsulitis.

Patients and methods: A total of 50 patients diagnosed with adhesive capsulitis were randomly divided into three groups. The first group received a suprascapular nerve block, the second group underwent posterior intra-articular hydro-dilatation, and the third group underwent shoulder interval hydro-dilatation. Patient assessment was conducted using visual analogue scale for pain, shoulder pain and disability index, and measurements of range of motion.

Results: Group 1 experienced rapid and sustained pain reduction (p-value < 0.001 at both baseline vs. first follow-up and baseline vs. second follow-up), with non-significant improvement in internal rotation after 12 weeks (p value = 0.330). Group 2 showed delayed improvement in internal rotation (p-value = 0.068), but more sustained pain reduction (p-value < 0.001) and improved range of motion in all directions at the 12-week mark. Group 3 exhibited rapid pain reduction (p-value < 0.001) and improved range of motion, but non-significant improvements in internal (p-value = 0.131) and external rotation (p-value = 0.052) after 12 weeks.

Conclusion: Although no significant differences were observed among the three groups, we recommend posterior intra-articular hydro-dilatation as it yielded the most promising and sustainable outcomes as regard pain reduction and range of motion improvement. Suprascapular nerve block is recommended for patients with prominent pain symptoms. Rotator interval hydro-dilatation is the least recommended intervention, being the most challenging and painful technique, and as it demonstrated a less sustained effect on range of motion. Key Points • This study aimed to find the best treatment modality for adhesive capsulitis through comparing the effects of suprascapular nerve block, posterior intra-articular hydro-dilatation, and hydro-dilatation of the shoulder interval. • Although no significant differences were found among three modalities, posterior intra-articular hydro-dilatation showed the best long-term outcomes for pain and range of motion. Suprascapular nerve block is recommended for patients with severe pain, while hydro-dilatation of the shoulder interval had less lasting benefits.