Hemiplegic shoulder pain management with supraspinatous nerve block: case series from Pahang, Malaysia

• Main Authors: Md Isa, Sharifah Aminah Az-Zahrah, Bahari, Siti Syakirin, Abu Hassan, Salmah Anim
• Format: Article
• Language: English; English
• Published: MRE Press 2023
• Subjects: RM147 Administration of Drugs and Other Therapeutic Agents; RM695 Physical medicine. Physical therapy
• Online Access: http://irep.iium.edu.my/105367/15/105367_Hemiplegic%20shoulder%20pain.pdf; http://irep.iium.edu.my/105367/2/image002.jpg; http://irep.iium.edu.my/105367/; https://www.signavitae.com
• Institution: Universiti Islam Antarabangsa Malaysia

Background and aims: Hemiplegic shoulder pain (HSP) is a common complication occurring in stroke survivors. Its incident is estimates to be around 10–22%. Patients with severe arm weakness with or without shoulder subluxation within 72 hours of stroke event are at higher risk of suffering from HSP at 8–10 weeks. HSP limits rehabilitation process, impedes patient function and reduces quality of life for stroke survivors. In complex management of HSP, it is known that addition of rehabilitation interventions such as suprascapular nerve block, botulinum toxin injection, suprascapular radiofrequency and dry needling were significantly more effective for pain management compared to conventional rehabilitation methods alone. This study aims to assess the efficacy of suprascapular nerve block as one of the management for post stroke patients with hemiplegic shoulder pain. Methods: A total of 3 patients with hemiplegic shoulder pain as a result of stroke were treated with supraspicapularnerve block under ultrasound guidance. The patients were assessed immediately post injection. Shoulder pain score was measured using the Numerical Rating Scale (NRS). Results: Following the nerve block there was significant improvement of pain scores. Evaluating from the NRS, there was an average of 58% percent pain reduction from initial scoring. Range of motion for shoulder abduction improved by a mean of 25% post injection. Conclusion: Supraspinatous nerve block is a safe and effective therapy for patients with hemiplegic shoulder pain.