Deans' stroke musings: Suprascapular Nerve Block for Shoulder Pain in the First Year After Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, October 22, 2013

Suprascapular Nerve Block for Shoulder Pain in the First Year After Stroke

Is this a possibility for helping your recovery along? You will need to bring it up to your doctors because they won't know about it.
http://stroke.ahajournals.org/content/44/11/3136.abstract.html?etoc

+ Author Affiliations

From the Department of Rehabilitation and Aged Care (Z.A.-W., M.C.) and Department of Rheumatology (E.M.S.), Flinders University, Daw Park, South Australia.

Correspondence to Zoe Adey-Wakeling, BMBS, Department of Rehabilitation and Aged Care, C Block, Repatriation General Hospital, Daws Road, Daw Park SA 5041. E-mail zoe.adey-wakeling@health.sa.gov.au

Abstract

Background and Purpose—Shoulder pain is a common complication after stroke that can impede participation in rehabilitation and has been associated with poorer outcomes. Evidence-based treatments for hemiplegic shoulder pain are limited. Suprascapular nerve block (SSNB) is a safe and effective treatment of shoulder pain associated with arthritic shoulder conditions, but its usefulness in a stroke population is unclear.

Methods—We undertook a randomized controlled trial assessing the effectiveness of SSNB in a population of 64 stroke patients (onset < 1 year) with hemiplegic shoulder pain. The primary outcome was pain measured on a visual analogue scale (VAS). Secondary outcomes were disability (Modified Rankin Scale, Croft Disability Index) and quality of life (EuroQol Health Questionnaire). All participants were assessed before randomization, and at 1, 4, and 12 weeks postintervention. Both groups continued with routine therapy.

Results—Although both intervention and control groups demonstrated reduction in pain score, participants who received SSNB consistently demonstrated superior, statistically significant pain reduction compared with placebo. Mean VAS reduction in the SSNB group was >18 mm greater than participants receiving placebo injection. The number needed to treat with SSNB to reduce 1 stroke survivor’s pain by 50% at 4 weeks is 4. No significant differences in function or quality of life were observed. No adverse events were reported.

Conclusions—Suprascapular nerve block is a safe and effective treatment for patients with hemiplegic shoulder pain.

Clinical Trial Registration—URL: http://www.anzctr.org.au. Unique identifier: ACTRN12609000621213.