The balloon is implanted in the shoulder and then pumped with fluid to the size of a small orange. This then acts as a cushion between the bone and damaged muscle and tendons, preventing further damage and allowing the inflamed tissue to heal.
Upon examination, the therapist locates the hyperirritable area — the trigger points.
Around one in five Britons develops shoulder pain at some time; the most common cause in the overs is a rotator cuff injury. The rotator cuff is shoulder joint group of muscles and tendons which secures the top of the arm into the shoulder joint.
Common rotator cuff injuries include tendonitis - where the tendons become inflamed through being overused or overloaded - and bursitis, where a fluid-filled pad that cushions the tendons becomes irritated and inflamed. A fall or lifting too heavy an item can also cause tears in the muscles or tendons of the cuff.
Rotator cuff injuries become more common with age because tendons and muscles weaken. Sportsmen and women involved in activities which require repetitive movements of the shoulders such as rowing and swimming, or people whose jobs require reaching, such as painting and window-cleaning, are particularly at risk.
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Some conditions including rheumatoid and osteoarthritis can also make injury more likely. Although a shoulder joint cuff injury can be treated with anti-inflammatory medication and physical therapy, in some cases surgery remains the only option.
Traditionally, this involves repairing any tears in the muscles or removing worn bone that may be jutting out and causing muscles and tendons to snag on it.
However, this carries the risks associated with a general anaesthetic. The new device, on trial at four centres in Italy and Israel, can be implanted as an outpatient under local anaesthetic. The treatment is aimed at increasing the size of the space between the bone and cuff to reduce contact and therefore pain. During the trial, patients had a tiny incision made in the skin using a special hollow implanting tool.
When it reached the rotator cuff, a folded and deflated balloon was inserted through the tool and left at the tip. A syringe connected to the other end of the implanting tool was then used to inflate the balloon using saline solution.
The procedure takes around ten minutes. Once inflated, the balloon - developed by Israel-based BioProtect - acts as a barrier between the injured tissue and the bone, allowing it to heal.
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Over time the balloon degrades, although research from pilot studies suggests that the benefits of the extra room in the shoulder remain - so, in theory, preventing the problem happening again. A spokeswoman shoulder joint Arthritis Research UK, which funds research into rotator cuff injuries, said the device sounded promising. The liquid gel turns into a solid once inside the joint and creates a kind of scaffold that helps new cartilage grow.
Cartilage acts as the body's shock absorber, stopping bones rubbing together. But once it has been damaged or worn away, it is not very good at shoulder joint.
Once the gel sets, it forms a kind of fibrous matrix made up of hundreds of tiny tunnels. A special ingredient in the gel then binds to certain growth factors in the blood - these are chemicals that, in high quantities, can stimulate the production of new cartilage.
With a high level of growth factors 'trapped' in the matrix, cartilage cells begin to thrive. T he gel, which is still undergoing testing, could be available in three to five years.
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