» Articles » PMID: 23705115

A Comparison of the Short-term Effects of a Botulinum Toxin Type a and Triamcinolone Acetate Injection on Adhesive Capsulitis of the Shoulder

Overview
Journal Ann Rehabil Med
Date 2013 May 25
PMID 23705115
Citations 9
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: To evaluate the short-term clinical effects of the intra-articular injection of botulinum toxin type A (BoNT-A) for the treatment of adhesive capsulitis.

Methods: A prospective, controlled trial compared the effects of intra-articular BoNT-A (Dysport; 200 IU, n=15) with the steroid triamcinolone acetate (TA; 20 mg, n=13) in patients suffering from adhesive capsulitis of the shoulder. All patients were evaluated using a Numeric Rating Scale (NRS) of the pain intensity and a measurement of the range of motion (ROM) at baseline (before treatment) and at 2, 4, and 8 weeks post-treatment.

Results: The NRS at 2 weeks (BoNT-A vs. TA; 5.0 vs. 5.2), 4 weeks (4.1 vs. 4.9) and 8 weeks (3.8 vs. 4.6) of both treatment groups were significantly lower than that measured at baseline (7.4 vs. 7.6). The ROM of patients' shoulders increased significantly from baseline in both treatment groups. There was no significant difference in the NRS of pain intensity or the ROM between the two groups. Reduction in the pain intensity score was maintained for 8 weeks post-injection in both groups. There were no significant adverse events in either treatment group.

Conclusion: The results suggest that there are no significant short-term differences between the intra-articular injections of BoNT-A and TA. Although BoNT-A has a high cost, it may be used as a safe alternative of TA to avoid the steroid-induced side effects or as a second-line agent, for patients who have failed to respond to the current treatments.

Citing Articles

Effect of ultrasound-guided injection of botulinum toxin type A into shoulder joint cavity on shoulder pain in poststroke patients: study protocol for a randomized controlled trial.

Zheng P, Shi Y, Qu H, Han M, Wang Z, Zeng Q Trials. 2024; 25(1):418.

PMID: 38937804 PMC: 11212400. DOI: 10.1186/s13063-024-08258-8.


Association of Range of Motion Deficit and Recurrence of Pain After Treatment of Adhesive Capsulitis.

Lee J, Lee J, Chang M Pain Ther. 2024; 13(2):241-249.

PMID: 38315379 PMC: 10928039. DOI: 10.1007/s40122-024-00578-6.


Cytokines' Role in the Pathogenesis and Their Targeting for the Prevention of Frozen Shoulder: A Narrative Review.

Alghamdi A, Alyami A, Althaqafi 2nd R, Alzeyadi A, Alrubaei F, Alyami A Cureus. 2023; 15(3):e36070.

PMID: 37056530 PMC: 10092900. DOI: 10.7759/cureus.36070.


Frozen shoulder.

Millar N, Meakins A, Struyf F, Willmore E, Campbell A, Kirwan P Nat Rev Dis Primers. 2022; 8(1):59.

PMID: 36075904 DOI: 10.1038/s41572-022-00386-2.


The Use of Botulinum Toxin for the Treatment of Chronic Joint Pain: Clinical and Experimental Evidence.

Blanshan N, Krug H Toxins (Basel). 2020; 12(5).

PMID: 32397671 PMC: 7291335. DOI: 10.3390/toxins12050314.


References
1.
Kong K, Neo J, Chua K . A randomized controlled study of botulinum toxin A in the treatment of hemiplegic shoulder pain associated with spasticity. Clin Rehabil. 2007; 21(1):28-35. DOI: 10.1177/0269215506072082. View

2.
Namazi H, Torabi S . Novel use of botulinum toxin to ameliorate arthrofibrosis: an experimental study in rabbits. Toxicol Pathol. 2007; 35(5):715-8. DOI: 10.1080/01926230701481923. View

3.
Hand G, Athanasou N, Matthews T, Carr A . The pathology of frozen shoulder. J Bone Joint Surg Br. 2007; 89(7):928-32. DOI: 10.1302/0301-620X.89B7.19097. View

4.
Tillander B, Franzen L, Karlsson M, Norlin R . Effect of steroid injections on the rotator cuff: an experimental study in rats. J Shoulder Elbow Surg. 1999; 8(3):271-4. DOI: 10.1016/s1058-2746(99)90141-6. View

5.
Zhibo X, Miaobo Z . Botulinum toxin type A affects cell cycle distribution of fibroblasts derived from hypertrophic scar. J Plast Reconstr Aesthet Surg. 2008; 61(9):1128-9. DOI: 10.1016/j.bjps.2008.05.003. View