Efficacy of intra-articular injection of botulinum toxin type A in refractory hemiplegic shoulder pain.

Abstract

OBJECTIVE:

To evaluate the efficacy of intra-articular injection of botulinum toxin type A (BTX-A) in relieving hemiplegic shoulder pain (HSP).

DESIGN:

Pilot study with assessments before and after BTX-A intra-articular injection.

SETTING:

Hospital rehabilitation department.

PARTICIPANTS:

Patients (N=5) with HSP refractory to standard treatments and pain score at rest greater than 7 on a pain visual analog scale (VAS) of 0 to 10cm.

INTERVENTION:

Intra-articular BTX-A injection.

MAIN OUTCOME MEASURE:

Variation in VAS score at rest and during 90° passive arm abduction 2 and 8 weeks after BTX-A intra-articular injection.

RESULTS:

Baseline VAS score was 8.7±1 at rest and 9.8±0.4 during passive arm abduction. It clearly decreased at 2 (1.5±1.1 at rest, P=.001; 3±1.2 during arm abduction, P<.001) and 8 weeks (1.5±1.2 at rest, P=.001; 2.3±1.1 during arm abduction, P<.001) after BTX-A intra-articular injection.

CONCLUSIONS:

We found a strong correlation between intra-articular BTX-A injection and pain relief in patients with HSP. This result could provide the rationale for blind randomized controlled trials designed to better evaluate the safety and efficacy of intra-articular BTX-A injection in patients with refractory HSP.

• Authors: Alberto Castiglione, Sergio Bagnato, Cristina Boccagni, Marcello C Romano, Giuseppe Galardi
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 92 Issue 7 Pg. 1034-7 (Jul 2011) ISSN: 1532-821X [Electronic] United States
• PMID: 21704782 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Aged
• Botulinum Toxins, Type A (therapeutic use)
• Female
• Hemiplegia (complications, etiology)
• Humans
• Injections, Intra-Articular
• Male
• Middle Aged
• Neuromuscular Agents (therapeutic use)
• Pain Measurement
• Pain, Intractable (drug therapy, etiology)
• Pilot Projects
• Shoulder Pain (drug therapy, etiology)
• Stroke (complications)
• Treatment Outcome