Ultrasound-guided pulsed radiofrequency for chronic shoulder pain - prospective study
Radiofrequência pulsada guiada por ultrassom para dor crônica no ombro: um estudo prospectivo
Rita Diogo Torgal Pinto, Joana Manuela Tenreiro Pinto, Maria Céu Loureiro, Cristina Cardoso, José Pedro Assunção
Abstract
Background and objectives
Chronic shoulder pain is a frequent cause of suffering and impaired quality of life. Treatment includes non-pharmacological and pharmacological therapies, and interventional procedures such as suprascapular nerve blocks and radiofrequency. This prospective study aims to evaluate the efficacy of ultrasound-guided pulsed radiofrequency of suprascapular nerve for chronic shoulder pain in a clinical setting.
Methods
Therapeutic efficacy was evaluated through pain intensity using numeric pain rating scale at baseline, immediately, 3 and 6 months after, and patient’s motor function improvement. The secondary outcome was patient satisfaction.
Results
A total of 34 patients were enrolled and all patients presented a reduction in the numeric pain rating scale immediately after treatment. Pain reduction from baseline to 6 months after the procedure was 34.4% and 36.9% static and dynamic, respectively. The median percentage reduction was statistically significant immediately, 3 and 6 months after. There was also an improvement in range of motion, 39.6% in abduction, 24.1% in flexion, and 29.5% in extension. Ninety percent of patients reported patient’s global impression of change superior to six.
Conclusion
This study concludes that ultrasound-guided pulsed radiofrequency of suprascapular nerve reduces pain intensity for at least 6 months, accompanied by improvement of motor function and higher levels of patients’ satisfaction. Therefore, this technique represents a valid analgesic approach to chronic shoulder pain.
Keywords
Resumo
Introdução
A dor crônica no ombro é causa frequente de sofrimento e prejuízo na qualidade de vida. O tratamento inclui terapias não farmacológicas e farmacológicas e procedimentos intervencionistas, como bloqueios do nervo supraescapular e radiofrequência. Este estudo prospectivo tem como objetivo avaliar a eficácia da radiofrequência pulsada guiada por ultrassom do nervo supraescapular para dor crônica no ombro em um ambiente clínico.
Métodos
A eficácia terapêutica foi avaliada através da intensidade da dor usando escala numérica de avaliação da dor no início do estudo, imediatamente, 3 e 6 meses após, e melhora da função motora do paciente. O desfecho secundário foi a satisfação do paciente.
Resultados
Um total de 34 pacientes foram incluídos e todos os pacientes apresentaram redução na escala numérica de avaliação da dor imediatamente após o tratamento. A redução da dor desde o início até 6 meses após o procedimento foi de 34,4% e 36,9% estática e dinâmica, respectivamente. A redução percentual mediana foi estatisticamente significativa imediatamente, 3 e 6 meses depois. Houve também melhora na amplitude de movimento, 39,6% na abdução, 24,1% na flexão e 29,5% na extensão. Noventa por cento dos pacientes relataram uma impressão global de mudança superior a seis.
Conclusão
Este estudo conclui que a radiofrequência pulsada do nervo supraescapular guiada por ultrassom reduz a intensidade da dor por pelo menos 6 meses, acompanhada de melhora da função motora e maiores níveis de satisfação dos pacientes. Portanto, esta técnica representa uma abordagem analgésica válida para dor crônica no ombro.
Palavras-chave
References
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Submitted date:
03/18/2021
Accepted date:
08/21/2021