Hyaluronic Acid is a natural occurring molecule and often used in the treatment of musculoskeletal conditions by leveraging its ability to work at reducing friction. It is extensively used in the treatment of osteoarthritis. Recent studies has reported good results in expanded use for the treatment of rotator cuff and shoulder pain.
Shoulder pain most commonly originates from the tendon structures of the rotator cuff. The rotator cuff is a system of four muscles that surround the shoulder joint. Tendon injury is often a result of repetitive stress and can range from micro-injury (tendonitis) to macro-injury (tendon tear). The medical treatment for micro-injury (tendonitis) has traditionally been steroid injection, physical therapy. Recent literature has focused on the potential downside of using steroid for the treatment of rotator cuff disease to the extent that it may be effective at providing pain relief but at the expense of reducing the overall potential for healing. With this in mind more attention has been given to the use of other injectable options namely Hyaluronic Acid.
We reported on the efficacy of using P-R-P in a prior discussion (Orthobiologics for Effective Treatment of Knee Pain). Another study was recently published that reported on the efficacy of hyaluronic acid in the treatment of shoulder pain related to rotator cuff pathology. In this study the treatment of rotator cuff tendonitis with a single injection of 1ml hyaluronic acid either high molecular weight or low molecular weight was found to be effective at reducing shoulder pain and improving quality of life measurements up to 6 months following treatment. The conclusion of the study was that treatment of rotator cuff pain with either high or low molecular weight hyaluronic acid was effective treatment.
According to Gregory Montalbano, MD, Orthopedic Surgeon and faculty NYU school of medicine “This study and others like it has opened the door for rethinking contemporary treatment algorithms in the management of shoulder pain and other musculoskeletal diagnoses.” “The field of orthobiologics, which is focused on natural and regenerative therapies for musculoskeletal pathology, more specifically arthritis and tendonitis, should begin to replace some of the more traditional approaches to these problems. In the same way that technology has changed our day to day lives such as the way we shop, socialize, work, consume news etc. it is going to change the way we treat disease.”
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