Ultrasound-guided 5% dextrose perineural therapy at the axillary nerve for the treatment of shoulder pain in patients with rotator cuff tendinopathy: a randomized, double-blind, sham-controlled trial

Timporn Vitoonpong; Suda Pipatbannakij; Sopatip Rerkmoung; Chernkhuan Stonsaovapak; Natthiya Tantisiriwat

doi:10.2478/abm-2026-0014

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Ultrasound-guided 5% dextrose perineural therapy at the axillary nerve for the treatment of shoulder pain in patients with rotator cuff tendinopathy: a randomized, double-blind, sham-controlled trial

Asian Biomedicine

Volume 20 (2026): Issue 2 (April 2026)

By: Timporn Vitoonpong, Suda Pipatbannakij, Sopatip Rerkmoung, Chernkhuan Stonsaovapak and Natthiya Tantisiriwat

Open Access

|Apr 2026

Figures & Tables

Ultrasound-guided dextrose PIT at quadrangular space (pAxN) white arrowhead, needle; pAxN, proximal part of the axillary nerve.

Ultrasound-guided injection at the superior lateral humeral level (dAxN) white arrowhead, needle; dAxN, distal part of the axillary nerve.

Study flow diagram. dAxN, distal part of the axillary nerve; pAxN, proximal part of the axillary nerve.

Estimated mean difference of VAS in pAxN and dAxN group compared with the sham group. dAxN, distal axillary nerve; pAxN, proximal axillary nerve; VAS, visual analog scale.

Estimated mean difference of ROM in pAxN and dAxN group compared with the sham group. dAxN, distal axillary nerve; pAxN, proximal axillary nerve; ROM, range of motion.

Comparison of the effects of pAxN and dAxN with the sham group immediately posttreatment and at 2- and 4-weeks follow-ups, as well as with in-group comparisons with baseline

Outcomes/time	Study groups			Comparison with the sham group
	Sham (n = 13)estimated mean (95% Cl)	pAxN (n = 13)estimated mean (95% Cl)	dAxN(n = 13)estimated mean (95%CI)	pAxN – Sham		dAxN – Sham
				Mean difference (95% Cl)	P	Mean difference (95% Cl)	P
VAS†
Baseline	6.31(5.52, 7.09)	6.47 (5.69, 7.24)	6.87 (6.08, 7.66)
Immediate	4.81(4.03, 5.60)**P = 0.003	5.48 (4.71,6.26)P = 0.052	4.22 (3.43,5.01)***P < 0.001	0.51 (−0.90,1.92)	0.480	−1.15(2.56,0.25)	0.108
2 weeks	4.42(3.63,5.21)***P < 0.001	4.68 (3.91,5.46)***P < 0.001	2.52 (1.73,3.31)***P < 0.001	0.10 (−1.31,1.51)	0.889	−2.46 (−3.87,-1.05)”	0.001
4 weeks	2.84 (2.05, 3.62)***P < 0.001	3.67 (2.90,4.45)***P < 0.001	1.91 (1.12,2.70)***P < 0.001	0.68 (−0.73, 2.08)	0.346	−1.49 (−2.89, −0.08)’	0.039
OSS-TH‡
Baseline	33.17(30.18, 36.17)	33.83 (30.88, 36.78)	33.54 (30.55,36.53)
4 weeks	22.94(19.95,25.94)***P < 0.001	24.21 (21.26,27.17)***P < 0.001	24.38 (21.40,27.37)***P < 0.001	0.62 (−5.28,6.51)	0.836	1.08 (−4.82,6.97)	0.717
Forward flexion ROM†
Baseline	149.97 (144.64,155.30)	150.77 (145.48,156.06)	149.50 (144.17,154.82)
Immediate	155.35 (150.02,160.68)P = 0.140	154.39 (149.09,159.68)P = 0.322	150.50 (145.17,155.82)P = 0.784	−1.77 (−11.89,8.35)	0.732	−4.39 (−14.50,5.73)	0.396
2 weeks	162.66 (157.33,167.99)**P = 0.001	157.46 (152.17,162.76)P = 0.067	156.03 (150.71,161.36)P = 0.073	−6.0 (−16.12,4.12)	0.245	−6.15 (−16.27, 3.96)	0.233
4 weeks	166.89 (161.56,172.22)***P < 0.001	160.92 (155.63,166.22)**P = 0.005	161.03 (155.71,166.36)**P = 0.002	−6.77 (−16.89,3.35)	0.190	−5.39 (−15.50,4.73)	0.297
Abduction ROM†
Baseline	136.72 (126.53,146.91)	138.47 (128.43,148.51)	138.66 (128.51,148.81)
Immediate	157.10 (146.91,167.30)**P = 0.001	144.62 (134.58,154.67)P = 0.332	146.74 (136.59,156.88)P = 0.203	−14.23 (−31.83, 3.37)	0.113	−12.31 (−29.91,5.29)	0.171
2 weeks	157.80 (147.61,167.99)**P = 0.001	154.62 (144.58,164.67)*P = 0.011	147.51 (137.36,157.65)P = 0.164	−4.92 (−22.52,12.68)	0.584	−12.23 (−29.83, 5.37)	0.173
4 weeks	163.26(153.07,173.45)***P < 0.001	168.47(158.43,178.51)***P < 0.001	155.97(145.82,166.11)**P = 0.006	3.46 (−14.14,21.06)	0.700	−9.23 (−26.83,8.37)	0.304
Internal rotation ROM†
Baseline	72.73 (66.84, 78.63)	71.00 (65.14, 76.85)	73.58 (67.69, 79.47)
Immediate	73.12 (67.22, 79.01)P = 0.923	82.15(76.30,88.00)**P = 0.005	80.50 (74.62,86.39)P = 0.080	10.77 (−0.19,21.73)	0.054	6.54 (−4.42,17.50)	0.242
2 weeks	69.81 (63.91,75.71)P = 0.460	78.69 (72.84,84.54)P = 0.052	75.50 (69.62,81.39)P = 0.627	10.62 (−0.35,21.58)	0.058	4.85 (−6.12,15.81)	0.386
4 weeks	84.27(78.37,90.17)**P = 0.004	85.23(79.38,91.08)***P < 0.001	82.81 (76.92,88.70)*P = 0.020	2.69 (−8.27,13.65)	0.630	−2.31 (−13.27,8.65)	0.680
External rotation ROM†
Baseline	66.49 (61.65,71.34)	65.43 (60.65, 70.20)	63.85(59.00,68.71)
Immediate	68.03 (63.18, 72.87)P = 0.638	66.97(62.19,71.74)P = 0.638	65.78 (60.92, 70.63)P = 0.557	0.00 (−9.07,9.07)	1.000	0.39 (−8.69,9.46)	0.934
2 weeks	71.11 (66.26,75.95)P = 0.158	65.04 (60.27,69.82)P = 0.906	73.08 (68.23, 77.94)**P = 0.005	−5.00(14.07,4.07)	0.280	4.62 (−4.46,13.69)	0.319
4 weeks	71.26 (66.41,76.11)P = 0.145	65.81 (61.03,70.59)P = 0.906	70.39 (65.53, 75.25)*P = 0.046	−4.39 (−13.46,4.69)	0.344	1.77 (−7.30,10.84)	0.702

Baseline characteristics of participants

Variables	Treatment groups
Variables	Control(n = 13)	pAxN(n = 13)	dAxN(n = 13)
Demographic data
Age, mean (SD)	45.77 (11.95)	44.31 (13.17)	45.23 (8.49)
Sex, n (%)
Female	10 (77)	8 (62)	8 (62)
Male	3 (23)	5 (38)	5 (38)
Duration of shoulder pain, n (%)
<6 months	6 (46)	7 (54)	5 (38)
≥6 months	7 (54)	6 (46)	8 (62)
Dominant side affected, n (%)	10 (77)	7 (54)	5 (38)
Prior treatments, n (%)
Medications	4 (31)	5 (38)	5 (38)
Manual exercise	6 (46)	5 (38)	6 (46)
Physical modality	3 (23)	2 (15)	3 (23)
Focus shock wave therapy	1 (8)	0 (0)	1 (8)
Subacromial corticosteroid injection	1 (8)	2 (15)	2 (15)
Dry needling	3 (23)	4 (31)	4 (31)
Outcomes at baseline
VAS, mean (SD)	6.01 (1.56)	6.35 (1.82)	7.29 (1.86)
OSS-TH, mean (SD)	33.15 (3.85)	34.46 (6.98)	32.92 (9.14)
Active shoulder ROM, mean (SD)
Forward flexion	151.92 (15.35)	154.46 (25.52)	143.85 (24.85)
Abduction	137.69 (31.07)	140.00 (43.83)	136.15 (37.03)
Internal rotation	74.62 (19.73)	68.85 (25.18)	73.85 (16.85)
External rotation	76.92 (14.94)	67.69 (28.48)	51.15 (31.70)

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DOI: https://doi.org/10.2478/abm-2026-0014 | Journal eISSN: 1875-855X | Journal ISSN: 1905-7415

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Language: English

Page range: 130 - 141

Published on: Apr 30, 2026

Published by: Chulalongkorn University

In partnership with: Paradigm Publishing Services

Publication frequency: 6 issues per year

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Assistive professions, nursing,

Basic medical science,

Basic medical science, other,

Clinical medicine,

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© 2026 Timporn Vitoonpong, Suda Pipatbannakij, Sopatip Rerkmoung, Chernkhuan Stonsaovapak, Natthiya Tantisiriwat, published by Chulalongkorn University
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 20 (2026): Issue 2 (April 2026)

Ultrasound-guided 5% dextrose perineural therapy at the axillary nerve for the treatment of shoulder pain in patients with rotator cuff tendinopathy: a randomized, double-blind, sham-controlled trial

Figures & Tables

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Comparison of the effects of pAxN and dAxN with the sham group immediately posttreatment and at 2- and 4-weeks follow-ups, as well as with in-group comparisons with baseline

Baseline characteristics of participants

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