Chronic Shoulder Pain – a New Approach

Many older folk – baby boomers and beyond – have chronic shoulder pain, due to osteoarthritis, a partial tear in the rotator cuff, or bursitis). Treatment always seems to be limited to 4 approaches – anti-inflammatory pain killers (like ibuprofen or Celebrex), physical therapy, corticosteroid injections, and surgery to clean and/or repair.

A new approach to chronic shoulder pain is injection of sodium hyaluronate, which is an FDA-approved treatment for osteoarthritis of the knee. Orthopedic surgeons have reported the use of this substance, which is sold as Hyalgan®, to help build up normal cartilage in damaged shoulder joints. Over 600 patients with chronic shoulder pain were given either 5 injections of Hyalgan, 3 injections of Hyalgan followed by 2 of saline, or 5 injections of saline, over a six month period.

Pain was scored on a 1 to 100 scale (‘none’ to ‘worst pain imaginable’). The average score at the start of the study was 65. Those with 5 injections of Hyalgan had a score of 35 after 6 months; those with 3 injections of Hyalgan scored 37; and those who got saline only scored 43.

Not much of a reduction, you may say. But it may be that saline alone not only had a placebo effect, but also irrigated the joint. So the effect can really be described as ‘halving the pain’, or thereabouts. Certainly better than nothing, and a possibility for those with chronic shoulder pain who’ve tried almost everything else.