Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis

Purpose: We aimed to investigate the effectiveness of suprascapular nerve block (SSNB) in patients with hemiplegic shoulder pain (HSP). Background: SSNB is widely used in various shoulder pains, but whether it is effective in HSP remains unknown. Methods: PubMed, Cochrane Library, and Embase databases were searched to identify potential citations. Randomized controlled trials meeting the eligible criteria were included in our analysis. The primary endpoint was Visual Analog Scale (VAS) with a maximum value of 100 and a minimum value of 0. Secondary endpoints were passive range of motion (PROM) that pain starts, and the PROM mainly included abduction, flexion, and external rotation. In addition, the upper extremity Fugl-Meyer assessment (FMA) was also included in our secondary endpoints. Results: Eight studies with 281 patients were included in our analysis. For VAS, there was no obvious difference between SSNB group and control group regardless of the follow-up period (< 4 weeks or >= 4 weeks), which were -6.62 (-15.76, 2.53; p = 0.16) and 1.78 (-16.18, 19.74; p = 0.85). For shoulder function, the PROM of abduction, flexion, and external rotation was similar between groups. However, motor function indicator FMA is lower in SSNB control than that in control group, with a mean difference (and 95% CI) of -2.59 (-4.52, -0.66; p = 0.008). Conclusion: SSNB is an effective way for HSP patients. Systematic Review Registration: Registration ID: CRD42021252429.

Automated summary

The study found that suprascapular nerve block is an effective treatment for hemiplegic shoulder pain patients. There was no significant difference in pain relief between the SSNB group and the control group. However, the Fugl-Meyer assessment score in the SSNB group was lower than in the control group in terms of motor function.