THURSDAY, Nov. 8 -- Botox seems to relieve shoulder pain in arthritis
sufferers, a preliminary study found.
"We don't recommend people start using it until we have the definitive
study," said study author Dr. Jasvinder Singh, a staff physician at the
Minneapolis VA Medical Center. He said his study was small, and more
patients needed to be assessed before the treatment could be
recommended.
Singh was to present his findings Friday at the American College of
Rheumatology annual meeting, in Boston.
Singh and his colleagues randomly assigned 43 patients with
moderate-to-severe osteoarthritis pain in their shoulders to one of two
groups. One group received a single dose of the botulinum toxin type A and
lidocaine, a local anesthetic. The other group got a dose of saline (salt
water) plus the lidocaine. Neither group knew what they were receiving.
Osteoarthritis is the "wear-and-tear" type of arthritis, and the risk for
it increases with age, obesity and other factors. About 21 million
Americans have this form of arthritis, according to estimates from the
Arthritis Foundation.
More than 5 percent of adult Americans suffer shoulder pain lasting more
than a month in a given year, according to Singh. At the start of the
study, the participants' pain levels were greater than 4.5 on a scale of
zero to 10, with 10 being the worst pain.
The researchers compared the pain levels before the botulinum treatment to
levels assessed 28 days later. They found that 38 percent of the botulinum
group had a 30 percent or better reduction in their pain scores, compared
to 9 percent of the saline group. Those who got botulinum also reported
more improvement in shoulder function than the saline group.
The toxin may work, Singh speculated, by reducing the release of certain
proteins from nerves in the joint. And that, in turn, may decrease the pain
sensation.
Dr. John Hardin is chief science officer at the Arthritis Foundation, and a
professor of medicine at Albert Einstein College of Medicine, in New York
City. He agreed that more study of botulinum for arthritis pain was needed
but was optimistic. "It appears very promising, that this is useful in
achieving pain relief," he said.
Hardin added a caveat, however: "It probably needs to be made clear this is
not thought of as an intervention that stops the progression of the
disease." And he warned those who might get the treatment that just because
the pain was reduced didn't mean the disease had gone away.
"It's still in the experimental stage," Hardin said.
Besides easing facial wrinkles, Botox is also used to treat bladder
problems, migraine headaches and excess sweating, among other
conditions.
The new study was funded by the North Central chapter of the Arthritis
Foundation, the Mayo Clinic Center for Clinical and Translational Research,
and the Minneapolis VA Medical Center. In the past, Singh has received
travel funds for other research projects from Allergan Pharmaceuticals,
which makes Botox, he said.
More information
For more about arthritis treatments, visit the Arthritis Foundation -
http://www.arthritis.org/ .
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