Treatment of frozen shoulder with intra-articular injection of botulinum toxin in shoulder joints.

Frozen shoulder, or adhesive capsulitis, is a disease of chronic inflammation and fibrosis involving the shoulder joints. The disease is challenging in clinical practice due to painful treatment course, with disease evolution usually lasting weeks or even months, causing significant discomfort and functional loss. Botulinum toxin (BTX) has been discovered to possess abilities in pain management at various clinical diseases. The actual mechanism is still under investigation, and involves inhibition of neurotransmitter release. In addition, BTX is also found to retard process of fibrosis, which is also a key issue in pathogenesis of frozen shoulder. Therefore, we hypothesize that intra-articular injection of BTX can be an effective alternative for treatment of frozen shoulder.