Effects of ultrasound-guided intraarticular botox vs. corticosteroids for shoulder osteoarthritis

Abstract

Background: Shoulder osteoarthritis (OA) is a painful condition in which movement of the shoulder becomes restricted. Treatment is aimed at pain reduction and maintain or improve functions. Intra-articular steroid injections have proven to be an effective and cost-effective treatment option. However, long-term use can weaken the shoulder tendons and cause histological changes. Recently, botulinum toxin has been evaluated for the treatment of the chronic joint pain. Its injection into the painful shoulder joints may inhibit the inflammatory mediators and the neuropeptide release which act on articular nociceptors and produce pain.
Objective: The present study compared the efficacy of ultrasound-guided intra-articular Botox and corticosteroid injections in glenohumeral joint in terms of reduction of pain scores and enhancing range of movement in patients with shoulder OA.
Methodology: Fifty eligible patients with shoulder OA were randomly assigned to two groups of Botox and corticosteroid (each with 25 patients). Ultrasound-guided intra-articular injections were randomly performed in all participants. Patients were evaluated in terms of effect on pre-procedure pain scores, range of abduction, internal rotation and external rotation, at 2 weeks and 12 weeks after injection. Two-way ANOVA and t-tests were utilized to analyze the data.
Results: The study results indicated that the injection of Botox and corticosteroid in the shoulder joint cause reduction in pain and increased range of movements of the patients with glenohumeral OA. Botox injection exerts more long-lasting effects in comparison to the corticosteroid group. Mean pain scores were lower in Botox group in comparison to the steroid group (2.75 vs. 4.24); patients in the Botox group experienced more pain reduction at week-12 and more increase in range of abduction, internal rotation and external rotation.