Many patients complain of hemiplegic shoulder pain following stroke. Here, the
effectiveness of pulsed radiofrequency stimulation of the suprascapular nerve is
compared with intra-articular corticosteroid injection for chronic hemiplegic
shoulder pain following stroke. This single-center, prospective, randomized
controlled study included 20 patients with hemiplegic shoulder pain after stroke,
randomly assigned to the pulsed radiofrequency and intra-articular corticosteroid
injection treatment groups (n = 10 in each). Hemiplegic shoulder pain
severity was measured by numeric rating scale and passive shoulder range motion
was assessed at baseline and one and two months after each procedure. Compared to
the baseline numeric rating scale scores, post-treatment scores decreased
significantly in both groups (p 0.001). However, score reduction
through time was significantly greater for intra-articular corticosteroid
injection for pulsed radiofrequency (p 0.001). Similarly, a
significant post-treatment increase was observed in almost all range of motion
measurements in both groups (pulsed radiofrequency group: flexion, p =
0.015; abduction, p = 0.014; external rotation, p = 0.038;
internal rotation, p = 0.063; intra-articular corticosteroid injection
group: all range of motion, p 0.001). Moreover, the measurements for
all ranges of motion in the intra-articular corticosteroid injection group were
significantly higher than those in the pulsed radiofrequency group (p 0.001). Thus, intra-articular corticosteroid injection appears more effective
than pulsed radiofrequency for control of hemiplegic shoulder pain, whereas,
pulsed radiofrequency of the suprascapular nerve has minimal effect. However, in
patients at risk for developing complications following corticosteroid
injections, pulsed radiofrequency of the suprascapular nerve may be an option in
management of hemiplegic shoulder pain.