title: Effectiveness of Botulinum Toxin for Shoulder Pain Treatment: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To evaluate the current evidence of the effectiveness of botulinum toxin (BTX) treatment for shoulder pain.
  
  
  METHODS
  Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Web of Science, and Scopus were searched from inception through week 18 of 2015.
  
  
  METHODS
  Randomized controlled trials comparing the clinical efficacy (pain intensity and shoulder range of motion [ROM]) of BTX injection to conventional therapy (steroid or placebo injection) were included.
  
  
  METHODS
  Two reviewers independently screened abstracts and full texts. The results of the pain intensity and shoulder ROM were extracted and presented in the form of mean and SD. We constructed random-effects models and calculated the mean difference (MD) for continuous outcomes. A total of 219 articles were identified, of which 9 articles were eligible for the final analysis.
  
  
  RESULTS
  The analysis indicated a statistically significant decreased pain score in the BTX therapy group compared with the control group, with the MD=1.35 (95% confidence interval [CI], .80-1.91; P<.001; I(2)=81%). Patients who received BTX therapy were more likely to have a significant increase in shoulder abduction ROM than patients in the control group, with the MD=8.02 (95% CI, 1.17-14.88, P=.02, I(2)=89%).
  
  
  CONCLUSIONS
  Compared with conventional (steroid or placebo injection) therapy, BTX injections have beneficial effects for adult patients with shoulder pain, evidenced by improved pain scores and ROM.
authors.affiliation: Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China. Electronic address: wutao1880@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Rehabilitation Medicine, Alxa League Central Hospital, Alxa, Inner Mongolia Autonomous Region, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Hai Xin
authors.initials: HX
authors.lastname: Song
authors.affiliation: Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Rehabilitation Medicine, Hangzhou Hospital of Zhejiang Chinese Armed Police Force, Hangzhou, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Jian Hua
authors.initials: JH
authors.lastname: Li
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents; D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D059408:Pain Management; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D020069:Shoulder Pain / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D009465:Neuromuscular Agents; D001905:Botulinum Toxins
keywords: Botulinum toxins; Rehabilitation; Review; Shoulder pain