Scattergood Sean David, Hassan Abdul, Williams Mark
University of Bristol, Bristol, UK.
North Bristol NHS Trust, Bristol, UK.
Eur J Orthop Surg Traumatol. 2025 Apr 21;35(1):162. doi: 10.1007/s00590-025-04287-4.
Chronic shoulder pain affects 2.4-30% of adults at any given time because of a wide variety of underlying pathologies. Treatment of chronic shoulder pain should attempt to address the underlying cause, if possible, either through surgical or non-surgical means. Routine non-operative care involves analgesia, physiotherapy and perhaps injection of corticosteroid at the appropriate site. A suprascapular nerve block (SSNB) is a minimally invasive, low-risk procedure which offers analgesia for patients. This review evaluates the effectiveness of SSNB in reducing shoulder pain at a 3-month follow-up, in comparison to standard non-operative care.
A literature search was conducted across Medline, Embase, Cochrane, ISRCTN and clinicaltrial.gov databases from inception to November 2024. Ninety publications were screened by abstract followed by full text, by the authors against inclusion criteria, and risk of bias was assessed using the RoB 2 tool.
Five randomised studies were included for analysis, presenting a heterogeneous mix of intervention, study populations and outcome measures. The two studies performing SSNB with local anaesthetic (LA) and corticosteroid found a significant reduction in pain at 3 months. In contrast, compared to studies using LA alone did not demonstrate the same level of efficacy.
Suprascapular nerve block is an effective analgesic option for chronic shoulder pain, which can be offered to patients as part of a shared decision-making approach. While studies suggest efficacy of combined LA and corticosteroid, limitations such as heterogeneity, variability in result reporting and short follow-up periods reduce the strength of the evidence.
由于多种潜在病理因素，慢性肩痛在任何特定时间影响2.4%-30%的成年人。慢性肩痛的治疗应尽可能通过手术或非手术手段解决潜在病因。常规非手术治疗包括镇痛、物理治疗，可能还包括在适当部位注射皮质类固醇。肩胛上神经阻滞（SSNB）是一种微创、低风险的手术，可为患者提供镇痛。本综述评估了与标准非手术治疗相比，SSNB在3个月随访时减轻肩痛的有效性。
对Medline、Embase、Cochrane、ISRCTN和clinicaltrial.gov数据库从创建到2024年11月进行文献检索。作者根据纳入标准对90篇出版物进行摘要筛选，然后进行全文筛选，并使用RoB 2工具评估偏倚风险。
纳入五项随机研究进行分析，这些研究在干预措施、研究人群和结局指标方面存在异质性。两项采用局部麻醉剂（LA）和皮质类固醇进行SSNB的研究发现，3个月时疼痛显著减轻。相比之下，与单独使用LA的研究相比，未显示出相同水平的疗效。
肩胛上神经阻滞是慢性肩痛的一种有效镇痛选择，可作为共同决策方法的一部分提供给患者。虽然研究表明LA和皮质类固醇联合使用有效，但诸如异质性、结果报告的可变性和随访期短等局限性降低了证据的强度。
