Intra-articular corticosteroid injections versus pulsed radiofrequency in painful shoulder: a prospective, randomized, single-blinded study.
OBJECTIVE
Chronic shoulder pain treatment is known to be a difficult and long process. The objective of this study is to compare the efficacy of intra-articular corticosteroid injection and pulse radiofrequency (PRF) applied to the suprascapular nerve in patients with shoulder pain.


METHODS
Fifty patients with shoulder pain were included in the study. Patients were randomly allocated into group 1 (intra-articular injection of corticosteroid) and group 2 (PRF to the suprascapular nerve). Outcome measures included a pain scale (visual analog scale; VAS), range of motion, Shoulder Pain and Disability Index (SPADI), the Short Form-36, Beck Depression Scale questionnaires, and paracetamol consumption.


RESULTS
In both groups, significant improvement was observed in all weeks in VAS, range of motion (active-passive), and SPADI subscores (P<0.05). Improvement was detected in most of the Short Form-36 scores at the end of the treatment in both groups (P<0.05), whereas no significant change was observed in Beck Depression Inventory score (P>0.05). When the groups were compared, a significant difference was found between the groups in favor of group 1 in terms of VAS at night in weeks 1, 4, and 12; VAS at rest in weeks 1 and 4; and VAS during movement in week 1 (P<0.05). There was also a significant difference in favor of group 1 observed in weeks 1, 4, and 12 in SPADI pain and total subscores (P<0.05). Paracetamol consumption was observed to be lower in group 1 (P<0.05).


CONCLUSIONS
Intra-articular injection of corticosteroid and PRF applied to the suprascapular nerve are effective in the treatment of painful shoulder. When 2 treatments are compared, it may be concluded that intra-articular steroid injection was more effective especially in the first weeks regarding pain than the PRF. Further studies are needed to confirm these results in the prospective treatment guidelines.
Eyigor
Can
C
Department of Anesthesiology, Pain Clinic, Faculty of Medicine, Ege University, Izmir, Turkey.
Eyigor
Sibel
S
Korkmaz
Onur K
OK
Uyar
Meltem
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000503:physiopathology*; D020069:Shoulder Pain / Q000628:therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones