Intra-articular corticosteroid injections versus pulsed radiofrequency in painful shoulder: a prospective, randomized, single-blinded study.

OBJECTIVE: Chronic shoulder pain treatment is known to be a difficult and long process. The objective of this study is to compare the efficacy of intra-articular corticosteroid injection and pulse radiofrequency (PRF) applied to the suprascapular nerve in patients with shoulder pain.

METHODS: Fifty patients with shoulder pain were included in the study. Patients were randomly allocated into group 1 (intra-articular injection of corticosteroid) and group 2 (PRF to the suprascapular nerve). Outcome measures included a pain scale (visual analog scale; VAS), range of motion, Shoulder Pain and Disability Index (SPADI), the Short Form-36, Beck Depression Scale questionnaires, and paracetamol consumption.

RESULTS: In both groups, significant improvement was observed in all weeks in VAS, range of motion (active-passive), and SPADI subscores (P<0.05). Improvement was detected in most of the Short Form-36 scores at the end of the treatment in both groups (P<0.05), whereas no significant change was observed in Beck Depression Inventory score (P>0.05). When the groups were compared, a significant difference was found between the groups in favor of group 1 in terms of VAS at night in weeks 1, 4, and 12; VAS at rest in weeks 1 and 4; and VAS during movement in week 1 (P<0.05). There was also a significant difference in favor of group 1 observed in weeks 1, 4, and 12 in SPADI pain and total subscores (P<0.05). Paracetamol consumption was observed to be lower in group 1 (P<0.05).

CONCLUSIONS: Intra-articular injection of corticosteroid and PRF applied to the suprascapular nerve are effective in the treatment of painful shoulder. When 2 treatments are compared, it may be concluded that intra-articular steroid injection was more effective especially in the first weeks regarding pain than the PRF. Further studies are needed to confirm these results in the prospective treatment guidelines.