# Hemiplegic shoulder pain, a combined approach with suprascapular nerve block and intra-articular corticosteroid injections: a case series

## TL;DR

A combined treatment of suprascapular nerve block and corticosteroid injection effectively reduces pain and improves shoulder mobility in patients with hemiplegic shoulder pain.

## Contribution

This case series demonstrates the efficacy and safety of a combined infiltration approach for treating hemiplegic shoulder pain.

## Key findings

- Pain intensity significantly decreased from 6.5 to 1.9 on the VAS at one month.
- Passive range of motion improved significantly in abduction, flexion, and external rotation.
- Benefits were maintained at three months with no serious complications observed.

## Abstract

Hemiplegic shoulder pain (HSP) is a prevalent and disabling condition affecting patients after stroke or traumatic brain injury. There is currently no consensus regarding infiltrative strategies. A combined approach, involving suprascapular nerve block and intra-articular corticosteroid injection, has been proposed for HSP and capsulitis, yet evidence remains limited.

This study presents the results (efficacy and safety) of this combined approach to alleviate pain and improve passive range of motion (PROM).

A retrospective, multicenter observational study (36 patients).

At 1 month, the mean pain intensity (visual analogue scale VAS) significantly decreased from 6.5 ± 1.5 at baseline to 1.9 ± 2.1, and PROM showed significant improvement across all three planes (mean PROM gains: 28.4° in abduction, 29.2° in flexion, and 13.4° in external rotation). The benefits were largely maintained at 3 months, and no serious complications were observed (one vasovagal episode).

The combined approach is a clinically feasible, safe, and effective method for treating HSP in PRM settings.