Effect of Ultrasound-guided Suprascapular Nerve Block Versus Intra-articular Corticosteroid Injection for Frozen Shoulder
Effect of Ultrasound-guided Suprascapular Nerve Block Versus Intra-articular Corticosteroid Injection for Frozen Shoulder
The investigators aim to compare the effect of ultrasound-guided suprascapular nerve block
 and intra-articular corticosteroid injection for frozen shoulder in pain control, improvement
 of range of motion, quality of life, and function.
The inclusion criteria is: 1. unilateral side involvement; 2. ≥50% loss of passive ROM
 (external rotation or abduction) in the glenohumeral joint comparing to the unaffected side;
 3. duration of symptoms ≥3 months. 4. age≥ 20year old.

 The exclusion criteria include: 1. ever received manipulation of the affected shoulder
 with/without anesthesia; 2. systemic disease, severe degeneration, or trauma involving the
 shoulder (ie, rheumatoid arthritis, osteoarthritis, history of injury to the labrum or
 articular cartilage or malignancies in the shoulder region, etc.); 3. neurologic diseases
 such as stroke or peripheral nerve neuropathy that have already affect the activity of
 shoulder; 4.pain or disorders of the cervical spine, elbow, wrist, or hand; 5.a history of
 drug allergy to local or corticosteroids; 6. Pregnancy or lactation; and 7. Received
 corticosteroids, or hyaluronic acid intra-articular injection into the affected shoulder
 during the preceding 4 weeks 70 participants will be randomly divided to SCNB group and IACI
 group. Each subject in either group will receive 2 times of injection in a two-weekly
 interval. After injection, each subject in either group will receive the same protocol of
 physiotherapy program for 2 months. Outcome measures include the SPADI, the SDQ, active and
 passive ROM of the affected shoulder, and SF-36. Evaluation will be performed at baseline and
 at 4 weeks and 12 weeks after the beginning of the treatment. Statistics will be performed
 after completing the patients' treatment and evaluations.

 A Shapiro-Wilk test will be applied to ensure that all the calculated variables followed a
 normal distribution. Subsequently, a 2-by-3, 2-way mixed-model analysis of variance, which
 has 1 between-subject factor (group: SCNB and IACI) and 1 within-subject factor (evaluation
 time: pretreatment, 4 weeks after beginning treatment, and 12 weeks after the beginning of
 the treatment), will be performed. Pair-wise comparisons between groups will be performed
 using an independent t test when a significant interaction is found; otherwise, the main
 effects are reported. When a time effect is found, a post hoc analysis will be performed
 using a polynomial test to determine the trend (linear or quadratic). All significance levels
 are set at alpha=.05, and SPSS version 15.0a will be used for all the statistical analyses.
Inclusion Criteria:

 1. unilateral side involvement.

 2. ≥50% loss of passive ROM (external rotation or abduction) in the glenohumeral joint
 comparing to the unaffected side.

 3. duration of symptoms ≥3 months.

 4. age≥ 20year old.

 Exclusion Criteria:

 1. ever received manipulation of the affected shoulder with/without anesthesia.

 2. systemic disease, severe degeneration, or trauma involving the shoulder. (ie,
 rheumatoid arthritis, osteoarthritis, history of injury to the labrum or articular
 cartilage or malignancies in the shoulder region, etc.)

 3. neurologic diseases such as stroke or peripheral nerve neuropathy that have already
 affect the activity of shoulder.

 4. pain or disorders of the cervical spine, elbow, wrist, or hand.

 5. a history of drug allergy to local or corticosteroids.

 6. Pregnancy or lactation.

 7. Received corticosteroids, or hyaluronic acid intra-articular injection into the
 affected shoulder during the preceding 4 weeks.