Comparison of the Effectiveness of the Ultrasound Guided Injections in Patients With Shoulder Impingement Syndrome

Study Overview
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Brief Summary
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Shoulder pain, which is the third most common cause of musculoskeletal pain, has different etiologies. Muscle, bone structures and connective tissue pathologies can cause shoulder pain. Impingement syndrome (IS), which can cover many terms such as rotator cuff disorders, tendinitis and tears, is one of the most common pathologies of shoulder pain.

Detailed Description
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The hypothesis of this study was that injection types including ACJ would increase treatment efficacy.Therefore, this study investigated the six-month follow-up results of patients undergoing SA injection and SSNB and those receiving SA and ACJ injection.

Official Title
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Comparison of the Effectiveness of the Ultrasound Guided Subacromial, Acromioclavicular With Subacromial Injection and Suprascapular Nerve Block in Patients With Shoulder Impingement Syndrome ; A Randomized Controlled, Single Blind, Clinical Trial

Conditions
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Shoulder Impingement, Ultrasound Guided Injection

Intervention / Treatment
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* Drug: bupivacaine and methylprednisolone
* Drug: bupivacaine and methylprednisolone
* Drug: bupivacaine and methylprednisolone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients aged 18-65, who were suffering from shoulder pain for more than three months and who were diagnosed with IS. All patients included in the study were diagnosed with IS using Shoulder Magnetic Resonance imaging. Exclusion Criteria: the presence of cervical radiculopathy; undergoing shoulder operation before; the presence of central nervous system or the presence of rheumatological disease, and polyneuropathy; receiving physical therapy in the shoulder area with a diagnosis of IS within the last six months; and receiving any injection therapy in the past.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: prospective,randomized controlled, single blind
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: subacromial injection<br>ultrasound (US)-guided subacromial injection | Drug: bupivacaine and methylprednisolone<br>* 5 mL of 0.25% bupivacaine containing 20 mg methylprednisolone was administered to the subacromial area<br>|
| Active Comparator: acromioclavicular joint and subacromial injection<br>ultrasound (US)-guided acromioclavicular joint and subacromial injection | Drug: bupivacaine and methylprednisolone<br>* 5 mL of 0.25% bupivacaine containing 20 mg methylprednisolone was administered to the subacromial area for the subacromial+acromioclavicular joint injection. In addition, 2 mL of 20 mg methylprednisolone and the same concentration of local anaesthetic were injected into the acromioclavicular joint<br>|
| Active Comparator: suprascapular nerve block<br>ultrasound (US)-guided suprascapular nerve block | Drug: bupivacaine and methylprednisolone<br>* suprascapular nerve block was administered with a mixture of 10 mL of 0.25% bupivacaine and 40 mg methylprednisolone<br>* Other names: suprascapular nerve block;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale (VAS) | for pain. 0: no pain at all, 10: worst pain imaginable | six month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder pain and disability index (SPADI) | This scale was developed to measure pain and disability associated with shoulder pain. It consists of two parts evaluating pain and disability. | six month | 
| Short-Form 12 (SF-12) | The SF-12 has a physical (SF12-PCS) and mental (SF12-MCS) state assessment scale | six month |