Effects of ultrasound-guided nerve hydro-dissection on severe post stroke shoulder pain: a pilot study.

Only 12 of 97 screened patients were enrolled, and no sample size calculation was performed, so the findings are preliminary. There was no sham procedure, so procedural placebo effects cannot be excluded. All patients received physiotherapy, occupational therapy, acupuncture and topical diclofenac; the study tested hydro-dissection added to that package, not any single component. Follow-up was only 4 weeks, so long-term pain relief and safety are unknown. Outcomes were mainly subjective clinical scores; ultrasound structural changes, spasticity and movement analysis were not measured. Posture was not quantitatively assessed, so the relationship between shoulder posture and outcome was not examined.

Do not conclude that ultrasound-guided nerve hydro-dissection is an established treatment for severe post-stroke shoulder pain or that it improves motor recovery. The study had only 12 patients, no sham control, and the upper-limb motor primary outcome did not differ between groups. All patients also received physiotherapy, occupational therapy, acupuncture and topical diclofenac.