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Objectives: To compare the mean improvement in pain on Visual Analogue Scale by Suprascapular Nerve block and Intra-articular steroid injection in patients with hemiplegic shoulder pain. Study Design: Randomized Controlled Trial Place and Duration of Study: Pain Clinic, Armed Forces Institute of Rehabilitation Medicine Rawalpindi from 25th October 2017 to 24th April 2018 Patients & Methods: 60 patients with CVA and shoulder pain on hemiplegic side for at least 2 weeks were included in study after non-probability consecutive sampling after meeting inclusion criteria. Subjects were randomized by lottery into two groups; Group A receiving Suprascapular Nerve block with 5ml of 1% Lignocaine with Group B receiving Intra-articular 40mg Triamcinolone Acetonide plus 1 ml of 1% Lignocaine injections. Mean change in pain scores on VAS was calculated between score at baseline and at 4 weeks post-intervention Results: The mean age of patients in group A was 59.17 ± 9.81 years and in group B was 39.96 ± 11.11 years. Out of 60 patients, 34 (56.67%) were males and 26 (43.33%) were females with male to female ratio of 1.3:1. Mean duration of stroke was 7.50 ± 2.66 months. Mean pain change on VAS in Group A (Suprascapular Nerve block) was 3.83 ± 1.12 cm while in Group B (Intra-articular steroid injection) it was 2.17 ± 0.99 cm (p-value = 0.0001). Conclusion: This study concluded that Suprascapular Nerve block offered better improvement in hemiplegic shoulder pain on Visual Analogue Scale at 4 weeks as compared to intraarticular steroid injection.

BACKGROUND There is a wide variety of treatment modalities available for the self-limiting disease of the frozen shoulder. But, there is no definite evidence of superiority available one over the other. This study was planned to evaluate the functional outcome of combined hydraulic capsular distension by normal saline and intraarticular steroid injection followed by physiotherapy for treatment of frozen shoulder. MATERIALS AND METHODS 64 patients between age group of 45 to 70 years, that attended our Orthopaedic Department OPD for primary frozen shoulder between January 2012 to December 2016 were included in this study. They were divided into 2 groups. First group of patients (32) were treated with combined intracapsular distension of shoulder using normal saline and intraarticular steroid injection under local anaesthesia followed by physiotherapy. Three doses were given at interval of 2 weeks. Second group (32 pts.) were treated by analgesics and physiotherapy only. The patients were assessed at baseline, second week, sixth week, twelfth week and sixth months. All the patients were evaluated for functional improvement by measuring the range of active movement of shoulder. RESULTS Patients treated with arthrographic hydrodilatation and intraarticular steroid injection have significantly better functional outcome in second week of injection as evaluated by active range of movement of shoulder. CONCLUSION From this study, we concluded that arthrographic hydrodilatation by normal saline combined with intraarticular steroid injection under local anaesthesia followed by physiotherapy provided dramatic pain relief and improved shoulder movement as early as second week.