Comparison of Suprascapular Nerve Block and Capsular Hydrodilatation in Adhesive Capsulitis of Shoulder: A Randomized Controlled Trial

Adhesive capsulitis (AC) of the shoulder is characterized by painful, restricted shoulder ROM in patients with normal radiographs and has long been considered self-limiting with spontaneous resolution (over a period of 18–24 months) that renders invasive treatment modalities superfluous. However, even after a fair trial of conservative measures (e.g., physical modalities, anti-inflammatory medications, exercises, corticosteroid injections), it has been reported that around 30% of patients do not improve clinically, thereby prolonging their functional limitations, emotional and economic hardships. In patients who do not improve with conservative treatment, further invasive treatments (such as manipulation under anesthesia and arthroscopic lysis of adhesions) have been tried. However, there has been no universally accepted method regarding invasive treatment options for refractory cases. Suprascapular Nerve Block (SSNB) has been tried in refractory AC but suboptimal response and complications can occur especially with the surface landmark technique and in the hands of those with limited expertise. Some studies have shown capsular hydrodilatation as a potential non-surgical option in the management of AC. However, its role compared with more established treatments for AC remains undefined. The present study aims to compare the effect of Suprascapular Nerve Block (SSNB) and capsular hydrodilatation in refractory cases of AC of the shoulder. We hypothesize that capsular hydrodilatation is as efficacious as SSNB in refractory cases of AC of the shoulder.