A novel study conducted by Columbia University Medical Center has shown that sodium hyaluronate, originally intended for use in osteoarthritis, could be effective in the treatment of chronic shoulder pain as well. Until now, drug treatment with Cox-2 inhibitors or surgery was the only treatment options left for patients with chronic shoulder pain.
Approximately 1.5 million patients visit orthopedic surgeons annually, according to estimates of the National Institute of Musculoskeletal and Skin Diseases. Osteoarthritis and rotator cuff tears account for a majority of the causes for shoulder pain.
The drug was approved by the FDA in the year 1998, for treatment if knee pain in osteoarthritis. A 50% reduction in the shoulder pain following treatment with sodium hyaluronate has been documented. Following such promising results, the drug is being evaluated by the FDA.
The drug, a vital building block of healthy cartilage is being manufactured under the brand name Hyalgan, by Sanofi Aventis, a leading pharmaceutical company. The researchers analyzed the safety and effectiveness of the drug in a group of 602 patients, divided into three groups. One group of the drug received 5 injections of the drug over a period of 6 months. The second group members received 3 drug injections two saline injections, while the third group members received a placebo (five saline injections).
All the study participants had tried other forms of non-surgical therapy, such as physical therapy, steroid injections, oral pain killer medications, all in vain. The patients were subjected to X-ray examination of the shoulder to establish the diagnosis of osteoarthritis and to rule out fractures. The patients during the entire duration of the study were asked to record their pain level on a scale of 1 to 100, with 100 representing the worst pain experienced.
As expected, patients who had received sodium hyaluronate had the greatest reduction in their pain as revealed by their pain scores of 35 over the six-month period. Those under the second group also had pain reduction, with pain scores of 37, on an average.
The drug treatment was found to be relatively safe, with no adverse effects reported among the three groups. This effect was found to be true when the participants were on drug treatments for other conditions. 14%, 55% and 60% of the study members were on medications for diabetes, arthritis and cardiac problems respectively. The results of this promising study were presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held at Chicago.
More research into treatment of shoulder pain involving sodium hyaluronate, in a considerable number of patients with shoulder pain is needed before this treatment can be approved for clinical use.