title: A comparison of the short-term effects of a botulinum toxin type a and triamcinolone acetate injection on adhesive capsulitis of the shoulder.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Joo
authors.forename: Se-Jin
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Chang-Won
authors.initials: CW
authors.lastname: Kim
authors.forename: Jung-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Jung-Hoi
authors.initials: JH
authors.lastname: Koo
authors.forename: Sun-Hong
authors.initials: SH
authors.lastname: Song
keywords: Adhesive capsulitis; Botulinum toxin type A; Intra-articular injections