Pain Managment in Chronic Shoulder Pain

Ain Shams University

Status: Enrolling

Conditions: Chronic Pain Management

Treatments: Other: the effect of adding pulsed radiofrequency (PRF) modality to suprascapular nerve injection with ultrasound glenohumeral steroid in chronic shoulder pain patients

Study type: Interventional

Funder types: Other

Identifiers

NCT06106490

FMASU MD128/2023

Details and patient eligibility

About

The purpose of this study is to evaluate the effect of adding pulsed radiofrequency (PRF) modality to suprascapular nerve injection with ultrasound glenohumeral steroid in chronic shoulder pain patients focusing on both changes in pain and function scores

Full description

Shoulder pain is the second most prevalent musculoskeletal condition in adults which is frequently treated poorly and results in chronic pain .

The use of steroid injection has been demonstrated to be superior to conventional therapies, particularly non-steroidal anti-inflammatory drugs. Its impact is transient (4-6 weeks) and occasionally may not be clinically sufficient .

An alternate analgesic injection for the pain management of numerous shoulder diseases is the suprascapular nerve block (SSN) .

Although pulse radiofrequency analgesia typically lasts for a much longer period than nerve blocking, it has become increasingly popular to apply pulse radiofrequency to peripheral nerves.

Enrollment: 60 estimated patients

Sex: All

Ages: 21 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults aged from 21-60 years.
• Patients with American Society of Anesthesiologists (ASA) physical status I and II.
• Chronic shoulder pain (>3 months) and will undergo interventional treatment due to inadequate response to conservative treatments.

Exclusion criteria

• Refusal of procedure or participation in the study by patients.
• History of shoulder surgery, another intervention history between 3 months before and 1 year after the intervention applied.
• Patients with chronic pain syndrome due to other shoulder pathology (fibromyalgia, cervical discopathy, brachial plexus injury).
• Uncontrolled diabetes mellitus patients with glycated hemoglobin (HbA1C) levels of more than 7%.
• Patients with known history of allergy to the study drugs.
• Infection at site of injection.
• Cognitive or psychiatric illness that will lead to inability to cooperate, speak, or provide informed consent.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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60 participants in 2 patient groups

Suprasacapular nerve block

Active Comparator group

Description:

Patients will receive ultrasound guided intra articular Gleno-humeral steroid injection of Diprofos® (betamethasone 14 mg/ 2ml) and ultrasound guided suprascapular nerve block US SSN with 10mL of 0.25% preservative-free bupivacaine

Treatment:

Other: the effect of adding pulsed radiofrequency (PRF) modality to suprascapular nerve injection with ultrasound glenohumeral steroid in chronic shoulder pain patients

Pulsed Radiofrequency group

Active Comparator group

Description:

Patients will receive ultrasound guided intra articular Gleno-humeral steroid injection of Diprofos® (betamethasone 14 mg/ 2ml) and ultrasound guided suprascapular nerve block US SSN with 10mL of 0.25% preservative-free bupivacaine with application of pulse PRF at 42 Celsius of suprascapular nerve for 480 seconds.

Treatment:

Other: the effect of adding pulsed radiofrequency (PRF) modality to suprascapular nerve injection with ultrasound glenohumeral steroid in chronic shoulder pain patients