Comparison of Spinoglenoid Versus Suprascapular Notch Approaches for Ultrasound-Guided Distal Suprascapular Nerve Blocks for Shoulder Pain: A Prospective Randomized Trial

Background: Distal suprascapular nerve blocks (SSNB) can be performed at the level of the suprascapular notch (the preferred site) or at the level of the spinoglenoid notch. Objectives: To compare the efficacy and safety of spinoglenoid versus suprascapular notch approaches for ultrasound (US)-guided distal SSNB in patients with chronic shoulder pain. Study Design: Prospective randomized controlled trial. Setting: Outpatient physical medicine and rehabilitation outpatient clinic of a tertiary center. Methods: Eighty patients with chronic unilateral shoulder pain were included in this study. Patients were randomized into 2 groups: group 1 (SSNB at the level of the spinoglenoid notch) and group 2 (SSNB at the level of the suprascapular notch). The patients were evaluated for pain according to the Shoulder Pain and Disability Index (SPADI) and a secondary visual analog scale (VAS), as well as for the outcome measures of range of motion (ROM) and pain pressure threshold (PPT) at baseline and at one, 4, and 12 weeks after the injection. Results: Statistically significant improvement was observed in the SPADI and VAS scores and ROM measurements, and the PPT measurements were similar at all post-injection follow-ups in both groups. Changes in outcome measures were similar between the groups, except for some ROM measurements at the post-injection follow-ups. Limitations: Heterogeneity of shoulder pain etiologies. Conclusion: Both distal SSNB approaches significantly improved pain and disability scores in patients with chronic shoulder pain, with no observable differences in the short-to-medium term. SSNB performed at the level of the spinoglenoid notch is therefore not inferior in efficacy and safety to SSNB performed at the level of the suprascapular notch.