scholarly journals Comparative Effectiveness of Botulinum Toxin Injection for Chronic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials

Toxins ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 251 ◽  
Author(s):  
Po-Cheng Hsu ◽  
Wei-Ting Wu ◽  
Der-Sheng Han ◽  
Ke-Vin Chang
Keyword(s):  
Botulinum Toxin ◽  
Shoulder Pain ◽  
Shoulder Joint ◽  
Joint Pain ◽  
Myofascial Pain ◽  
Pain Treatment ◽  
Meta Analysis ◽  
Post Intervention ◽  
Reference Treatment ◽  
Chronic Shoulder Pain

Botulinum toxin (BoNT) injection is regarded as a promising treatment for musculoskeletal pain. However, its efficacy for treating chronic shoulder pain remains unclear. We investigated the effectiveness of BoNT injections for chronic shoulder pain by conducting a systematic search of electronic databases up to March 2020 for randomized control trials (RCTs) that used BoNT injections for chronic shoulder pain treatment. The primary outcome was the between-group comparison of pain reduction, quantified by the standardized mean difference (SMD). Nine RCTs comprising 666 patients were included and divided into two groups: one group with shoulder joint pain (n = 182) and the other group with shoulder myofascial pain (n = 484). Regarding shoulder joint pain, the efficacy of BoNT injections was similar to that of the reference treatment (SMD: −0.605, 95% confidence level [CI]: −1.242 to 0.032 versus saline; SMD: −0.180, 95% CI: −0.514 to 0.153 versus corticosteroids) at one month post-intervention, and was superior (SMD: −0.648, 95% CI: −0.1071 to −0.225 versus corticosteroids) between one and three months. Likewise, in terms of shoulder myofascial pain, the effectiveness of BoNT injections did not differ from the reference treatment (SMD: −0.212, 95% CI: −0.551 to 0.127 versus saline; SMD: 0.665, 95% CI: −0.260 to 1.590 versus dry needling and SMD: 1.093; 95% CI: 0.128 to 2.058 versus lidocaine) at one month post- intervention, and appeared superior (SMD: −0.314, 95% CI: −0.516 to −0.111 versus saline) between one and three months. Our meta-analysis revealed that BoNT injections could be a safe and effective alternative for patients with chronic shoulder pain.

Effectiveness of Botulinum Toxin for Shoulder Pain Treatment: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 96 (12) ◽  
pp. 2214-2220 ◽  
Author(s):  
Tao Wu ◽  
Yu Fu ◽  
Hai xin Song ◽  
Ye Ye ◽  
Yan Dong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Shoulder Pain ◽  
Pain Treatment ◽  
Meta Analysis

scholarly journals Neuromodulation of the Suprascapular Nerve

2014 ◽  
Vol 6;17 (6;12) ◽  
pp. E769-E773
Author(s):  
Foad Elahi
Keyword(s):  
Peripheral Nerve ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Nerve Stimulation ◽  
Shoulder Joint ◽  
Adhesive Capsulitis ◽  
Suprascapular Nerve ◽  
Shoulder Range Of Motion ◽  
Shoulder Range ◽  
Chronic Shoulder Pain

The shoulder joint is an enarthrodial or ball-and-socket joint. A complex network of anatomic structures endows the human shoulder with tremendous mobility, greater than any other joint in the body. Many pathologies can been found in those patients with chronic shoulder pain. The painful limitation of shoulder motion affects hand and arm motion as well; therefore, it significantly influences work performance and everyday activities as well as the quality of life. Therefore, the treatment of patients with chronic shoulder pain has major social and health economic implications. In this article we present a patient with a complex history of shoulder pathology including 7 surgeries that left the patient with chronic debilitating shoulder pain. She was suffering from chronic pain and limited mobility of the shoulder joint due to adhesive shoulder capsulitis. She was treated with a multimodality approach with the goals of increasing shoulder range of motion and decreasing her pain. This did not provide significant improvement. The suprascapular nerve supplies motor and sensory innervation to the shoulder, and can be easily accessible in the supraspinatus fossa. A suprascapular nerve block dramatically decreased her pain. This clinical observation along with confirmatory nerve block play an important role during the decision-making process for a trial period of electrical neuromodulation. She was followed for 3 months after the permanent implantation of a suprascapular nerve stimulator. Her pain and shoulder range of motion in all planes improved dramatically. Peripheral nerve stimulation (PNS) of the suprascapular nerve, in addition to multimodality pain management, is one approach to the difficult task of treating adhesive capsulitis with accompanying pain and the inability to move the shoulder. We conducted a literature review on PubMed and found no case describing a similar patient to our knowledge. Key words: Suprascapular nerve, neuromodulation, peripheral nerve stimulation, adhesive capsulitis, chronic shoulder pain

scholarly journals Chronic non-traumatic shoulder pain: evaluation with ultrasonography and conventional mr imaging

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M N Elaassar ◽  
A Emadeldin ◽  
D Z Zidan ◽  
H M Sakr ◽  
H Abdelazim
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Shoulder Joint ◽  
Supraspinatus Tendon ◽  
Radiology Department ◽  
Dominant Hand ◽  
Full Thickness ◽  
Duration Of Symptoms ◽  
Partial Thickness ◽  
Chronic Shoulder Pain

Abstract Background Shoulder pain is a common and disabling complaint. It is responsible for approximately 16 % of all musculoskeletal disorders1 Shoulder pain is defined as chronic when it has been present for longer than six months, regardless of whether the patient has previously sought treatment2. The most common causes of chronic shoulder pain are reported to be rotator cuff disorders, acromioclavicular joint (ACJ) disease and glenohumeral joint (GHJ) disorders3 Aim of the Work The aim of this study is to evaluate the role of both ultrasonography and conventional MRI imaging in diagnosing various causes of chronic shoulder pain not caused by trauma. Patients and Methods 101 patients were evaluated for chronic shoulder pain ranging in age from 20 to 70-years-old. They were referred to the radiology department (Ultrasound unit and MRI unit) at Ain Shams University hospitals during the period between September 2016 and June 2018, from orthopaedic, rheumatology and physical medicine departments. Once a patient satisfied the inclusion and exclusion criteria for this study, an elaborate history was taken from all the patients which was followed by a thorough clinical evaluation, in which duration of symptoms, affected side, dominant hand, range of movement was checked. Patients were subjected to sonographic evaluation of the shoulder joint followed by MRI of the affected shoulder with mean interval between sonography and MRI about 10 days (range, 5-15 days). Results Total of 101 patients with chronic shoulder joint pain were enrolled in our study. 58 % of the patients were in the age group of 41-55 years with mean age of 48 years. Majority (42 %) of patients had chronic shoulder pain over 6-9 months. Complaints mainly resided in the form of tenderness (65 %) and night pain (25 %). Females constituted most of the patients around 68% of the cases. Majority (72%) patients in our study had right hand dominance. 57 % of the sampled patients gave positive history of heavy use of the affected shoulder. 78 % of patients demonstrated acromion morphological changes that had a direct impact on the rotator cuff findings. Amongst the rotator cuff tendons, Supraspinatus tendon was the most common tendon to be involved in our study in both USG and MRI. USG detected 92 patients and MRI detected 96 patients with supraspinatus tendon pathologies which included tendinosis, tears and calcifications and other non-rotator-cuff related findings. Total of 53 were diagnosed as rotator cuff-tear, followed by subacromial-subdeltoid bursitis (n = 32), supraspinatus impingement (n = 14), calcific tendinitis (n = 7) respectively. Supraspinatus tendinopathy was the most common diagnoses (n = 51) followed by Partial thickness tear of supraspinatus (n = 19) then full thickness of supraspinatus (n = 17). USG showed a sensitivity of 52.6% and specificity of 87.8 %, NPV of 88.9 % and PPV of 50 % with 78.8 % MRI agreement for partial thickness tears. USG showed 88 % sensitive, 97% specific, had 97 % PPV, 100% NPV, and was 96 % accurate in diagnosing complete tendon tear. MRI had a higher efficacy for both full thickness as well as partial thickness tears, whereas USG had a higher efficacy for full thickness tears only. Our study shows MRI to be a highly sensitive as well as specific technique for differentiation among different shoulder pathologies.

scholarly journals Advances in botulinum toxin type A for the treatment of pain

2021 ◽  
Author(s):  
Shisheng Jiang ◽  
Chaoming Huang ◽  
Yantianyu Yang ◽  
Shuhan Gao ◽  
Zihan Lin ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Myofascial Pain ◽  
Pain Treatment ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Research Progress ◽  
Contaminated Food ◽  
Current Article ◽  
Foodborne Botulism

<i>Clostridium botulinum</i> (CB) is a Gram-positive anaerobic bacterium and a significant cause of food spoilage. Foodborne botulism occurs worldwide every year and even lead to death from respiratory distress in severe cases after eating botulism-contaminated food. The pathogenicity of CB lies in its ability to produce a potent neurotoxin, “botulinum toxin (BTX)”, for which eight different subtypes have already been isolated so far. Botulinum toxin type A (BTX-A) is widely used to treat critical clinical issues due to its good affinity and tolerability. Studies have shown that BTX-A injections effectively treat myofascial pain, inflammatory pain, and neuropathic pain. The current article mainly reviews the latest research progress using BTX-A in pain treatment during two years.

Intra-articular injections of botulinum toxin a for refractory joint pain: a systematic review and meta-analysis

2016 ◽  
Vol 31 (4) ◽  
pp. 435-443 ◽  
Author(s):  
Tao Wu ◽  
Hai-xin Song ◽  
Yan Dong ◽  
Ye Ye ◽  
Jian-hua Li
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Joint Pain ◽  
Botulinum Toxin A ◽  
Meta Analysis ◽  
Toxin A

Diabetes and shoulder joint pain, treatment with intra-articular steroid

2000 ◽  
Vol 50 ◽  
pp. 332
Author(s):  
S Haque ◽  
A Haque ◽  
K Nazimuddim ◽  
F Pathan ◽  
T Ahmed ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Joint Pain ◽  
Pain Treatment

scholarly journals Shoulder Strength and Physical Activity Predictors of Shoulder Pain in People With Paraplegia From Spinal Injury: Prospective Cohort Study

2015 ◽  
Vol 95 (7) ◽  
pp. 1027-1038 ◽  
Author(s):  
Sara J. Mulroy ◽  
Patricia Hatchett ◽  
Valerie J. Eberly ◽  
Lisa Lighthall Haubert ◽  
Sandy Conners ◽  
...  
Keyword(s):  
Physical Activity ◽  
Shoulder Pain ◽  
Shoulder Joint ◽  
Joint Pain ◽  
Spinal Injury ◽  
Strong Predictor ◽  
Study Entry ◽  
Activity Levels ◽  
Cord Injury

Background Shoulder joint pain is a frequent secondary complaint for people following spinal cord injury (SCI). Objective The purpose of this study was to determine predictors of shoulder joint pain in people with paraplegia. Methods/Design A 3-year longitudinal study was conducted. Participants were people with paraplegia who used a manual wheelchair for at least 50% of their mobility and were asymptomatic for shoulder pain at study entry. Participants were classified as having developed shoulder pain if they experienced an increase of ≥10 points on the Wheelchair User's Shoulder Pain Index in the 3-year follow-up period. Measurements of maximal isometric shoulder torques were collected at study entry (baseline), 18 months, and 3 years. Daily activity was measured using a wheelchair odometer, and self-reported daily transfer and raise frequency data were collected by telephone every 6 weeks. Results Two hundred twenty-three participants were enrolled in the study; 39.8% developed shoulder pain over the 3-year follow-up period. Demographic variables and higher activity levels were not associated with shoulder pain onset. Baseline maximal isometric torque (normalized by body weight) in all shoulder muscle groups was 10% to 15% lower in participants who developed shoulder pain compared with those who remained pain-free. Lower shoulder adduction torque was a significant predictor of shoulder pain development (log-likelihood test=11.38), but the model explained only 7.5% of shoulder pain onset and consequently is of limited clinical utility. Limitations Time since SCI varied widely among participants, and transfer and raise activity was measured by participant recall. Conclusions Participants who developed shoulder pain had decreased muscle strength, particularly in the shoulder adductors, and lower levels of physical activity prior to the onset of shoulder pain. Neither factor was a strong predictor of shoulder pain onset.

scholarly journals Does the Use of Botulinum Toxin Reduce the Intensity of Myofascial Pain in Adult Patients? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Letícia Maira Wambier
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Pain Relief ◽  
Saline Solution ◽  
Myofascial Pain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Cochrane Library ◽  
Similar Data

Objective: A systematic review was performed to evaluate if the use of botulinum toxin was able to reduce the intensity of myofascial pain compared to other treatments in adult patients. Material and Methods: A comprehensive search was carried out in the MEDLINE via Pub-Meb, Scopus, Web of Science, LILACS, BBO and Cochrane Library. In addition, the gray literature was also researched. The risk of bias tool from the Cochrane Collaboration was used by two independent reviewers for quality assessment of the studies. Results: A total of 4372 studies were identified, 9 remained in qualitative study, 8 of these studies were considered at “unclear” risk of bias and just one study was “low” risk of bias in the key domains. Only two studies presented similar data to be included in the meta-analysis. Both studies evaluated the pain relief used the botulinum toxin (BTX-A) versus saline solution. The meta-analysis demonstrated that after 3 months follow-up the pain relief was 15.70 (95 % confidence interval [CI] = 0.80 to 30.61; p = 0.04). Conclusion: The BTX-A reduced the intensity of myofascial pain compared to saline solution in adults after 3 months. However, further studies should be conducted to corroborate this finding.

Sign in / Sign up

Export Citation Format

Share Document