In a pilot study carried out at Burton Hospitals NHS Foundation Trust, patients with persistent shoulder pain who were treated with suprascapular nerve block (SSNB) injections achieved similar pain and functional benefits, regardless whether the treatment was administered by an anaesthetist or a physiotherapist.
As part of the study, 40 patients received an SSNB from a physiotherapist and 8 were treated by an anaesthetist. At 6 wk follow-up, the physiotherapy group showed a mean reduction in pain of 2.2 on a numerical rating scale (NRS) of 0 to 10. This was accompanied by a −1.3 improvement in patient-specific functional score (PSFS). Corresponding rates in those treated by anaesthetists were 1.3 and −1.4, respectively. At 6 mo follow-up, patients treated by physiotherapists maintained a mean reduction in pain of 2.0 on the NRS.
Persistent shoulder pain accounts for 15% of all musculoskeletal conditions and is associated with high patient burden and healthcare costs. Since stretching and strengthening exercises can sometimes aggravate pain in these patients in the short term, SSNB prior to a course of exercise could create an opportunity to proceed with more effective exercise rehabilitation in the short, medium and long term.
The success of the pilot service has resulted in a change to service delivery at Burton Hospitals NHS Foundation Trust. All patients attending the orthopaedic services who require a therapeutic SSNB are now referred to a physiotherapist rather than an anaesthetist.
Reference: Salt E, van der Windt DA, Chesterton L, Mainwaring F, Ashwood N, Foster NE. Physiotherapist-led suprascapular nerve blocks for persistent shoulder pain: Evaluation of a new service in the UK. Musculoskeletal Care. 2017 Jul 13 [Epub ahead of print]. doi: 10.1002/msc.1205. PMID: 28703390