Fat Tissue Injections Ease Stubborn Shoulder Pain in Wheelchair Users

Study Tests New Option When Standard Treatments Fail

Wheelchair users with spinal cord injuries face a difficult problem. They depend on their arms for nearly everything—pushing their chairs, transferring, and daily activities. This constant upper body use often leads to rotator cuff damage and chronic shoulder pain. When physical therapy, medications, and other standard treatments stop working, options become limited. Surgery means weeks of recovery, possibly switching to a power wheelchair, and needing help with basic tasks.

This pilot study explored whether micro-fragmented adipose tissue (MFAT)—specially processed fat from the patient's own body—could offer relief for these challenging cases.

Ten Patients with Long-Term Pain Enrolled

Researchers recruited ten adults who use wheelchairs due to spinal cord injury. All had moderate-to-severe shoulder pain lasting more than six months. Standard treatments had already failed for each participant. Ultrasound imaging confirmed rotator cuff disease in every case.

The treatment involved a single injection procedure. Doctors harvested a small amount of fat tissue from each patient's body. This tissue was then processed using the Lipogems system, which gently breaks down fat while preserving helpful cells called pericytes and mesenchymal stem cells. Using ultrasound guidance, doctors injected this processed tissue directly into damaged shoulder structures.

Nearly Eight in Ten Achieved Meaningful Pain Relief

The results were encouraging. Researchers tracked participants at six months and twelve months after treatment. Pain scores dropped significantly at both checkpoints compared to baseline measurements.

Key findings included:

• 78% of participants experienced at least 30% reduction in their wheelchair-related shoulder pain scores

• 78% showed meaningful improvement on a standard numerical pain rating scale

• 67% reported significantly less pain interference with daily activities

• All but one participant reported feeling better overall after treatment

These improvements held steady through the full twelve-month follow-up period.

No Serious Side Effects Reported Throughout Study

Safety was a primary focus of this pilot research. Throughout the entire study period, no significant adverse events occurred. This finding matters greatly for wheelchair users, who cannot afford complications that might limit their arm function even temporarily.

The minimally invasive nature of MFAT injection contrasts sharply with surgical alternatives. Traditional rotator cuff surgery requires hospitalization and extended recovery. Patients often need weeks of restricted arm use—a major hardship for anyone who relies on their arms for mobility.

Ultrasound Guidance Ensures Precise Placement

Doctors used real-time ultrasound imaging to guide every injection. This allowed them to target the specific damaged structures identified during screening. The supraspinatus tendon received treatment in all patients. When ultrasound revealed additional problems, doctors also injected other affected areas. These included the biceps tendon, infraspinatus tendon, and joints within the shoulder.

Physical examinations at each follow-up visit tracked changes in common rotator cuff tests. Ultrasound examinations at six and twelve months provided objective images of the treated tissues.

Larger Trial Now Underway Based on These Results

This pilot study was designed to prepare for a bigger, more rigorous trial. The researchers achieved their goals. They demonstrated that the treatment appears safe for wheelchair users with spinal cord injuries. They also found effect sizes large enough to justify continued research.

Based on these promising findings, a larger randomized controlled trial has been launched. This next study will compare MFAT injection against other treatments, providing stronger evidence about its effectiveness.

What This Means for Patients with Shoulder Pain

If you use a wheelchair and struggle with persistent rotator cuff pain, this research offers hope. MFAT injection may provide an option between failed conservative care and major surgery. The treatment uses your body's own tissue, requires no hospitalization, and showed meaningful benefits lasting at least one year.

However, this was a small pilot study without a comparison group. Larger trials are needed before drawing firm conclusions. Discuss with your doctor whether this approach might suit your specific situation while research continues.

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Source: Hogaboom et al., Unknown, 2021.