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CLINICAL TRIAL article

Front. Pain Res.
Sec. Musculoskeletal Pain
Volume 5 - 2024 | doi: 10.3389/fpain.2024.1490320

Lidocaine versus saline ultrasound-guided suprascapular nerve block combined with physical exercises for the rehabilitation of supraspinatus tendinitis: a randomized double-blind controlled trial

Provisionally accepted

The final, formatted version of the article will be published soon.

    Introduction: Shoulder pain is the third leading cause of musculoskeletal complaints in primary care clinics. Its prevalence varies from 14 to 34%. Among all the structures that can cause shoulder pain, the most vulnerable to injury is the tendon of the supraspinatus muscle. The ideal management protocol is still unknown. To date, little is known in the literature about the use of ultrasound-guided suprascapular nerve block as a treatment for supraspinatus muscle tendinitis. Our objective was to assess the effects of the association of a single ultrasound-guided suprascapular nerve block combined with home-based rotator cuff exercises to reduce pain and improve shoulder functioning in patients with supraspinatus tendinitis. Methods: We evaluated the effect of a single ultrasound-guided suprascapular nerve block on pain and functioning of people with supraspinatus tendinitis. Diagnosis was performed using the positive Jobe test. Due to large disparity between clinical and radiological findings, only clinical diagnostic criteria were used to select patients. This was a double-blind, randomized, controlled, clinical study in which patients in the intervention group (n=42) received a single injection of 5 ml of 2% lidocaine, while in the control group (n=41) patients underwent the same procedure receiving saline solution 0.9%. All patients received face to face instructions by an experienced physiotherapist and a leaflet explaining home-based exercises. Pain and functioning were assessed using the Shoulder Pain and Disability Index (SPADI) questionnaire before the procedure, one week and 12 weeks after the procedure. Results: Patients in both groups improved significantly since the initial evaluation until the 12th week. Intervention group SPADI (pre, 1 week, 12 weeks): 75.80 ± 18.96, 56.25 ± 31.37, 46.31 ± 31.41 (p<0.001); Control group SPADI: 75.49 ± 16.67, 50.51 ± 27.58, 49.37 ± 30.90 (p<0.001). However,there were no significant differences between groups (p=0.291). Discussion/conclusion: We concluded that both lidocaine and saline ultrasound-guided suprascapularnerve blocks reduce pain and improve shoulder functioning in patients with supraspinatus tendinitis.. Unexpectedly, the same block performed with saline showed similar results and effects. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02495818.

    Keywords: Rotator Cuff, Rotator cuff Injuries, supraspinatus tendinopathy, Nervous block, Pain Management

    Received: 03 Sep 2024; Accepted: 21 Oct 2024.

    Copyright: © 2024 Otani, Imamura, Rached, Alfieri, De Azevedo Neto and Hsing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Pericles T. Otani, University of São Paulo, São Paulo, Brazil

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.