Hemiplegic shoulder pain, a combined approach with suprascapular nerve block and intra-articular corticosteroid injections: a case series

Background: Hemiplegic shoulder pain (HSP) is a prevalent and disabling condition affecting patients after stroke or traumatic brain injury. There is currently no consensus regarding infiltrative strategies. A combined approach, involving suprascapular nerve block and intra-articular corticosteroid injection, has been proposed for HSP and capsulitis, yet evidence remains limited. Objective: This study presents the results (efficacy and safety) of this combined approach to alleviate pain and improve passive range of motion (PROM). Methods: A retrospective, multicenter observational study (36 patients). Results: At 1 month, the mean pain intensity (visual analogue scale VAS) significantly decreased from 6.5 ± 1.5 at baseline to 1.9 ± 2.1, and PROM showed significant improvement across all three planes (mean PROM gains: 28.4° in abduction, 29.2° in flexion, and 13.4° in external rotation). The benefits were largely maintained at 3 months, and no serious complications were observed (one vasovagal episode). Conclusion: The combined approach is a clinically feasible, safe, and effective method for treating HSP in PRM settings.