Effectiveness of Botulinum Toxin in the Treatment of Neuropathic Pain: A Literature Review

Abstract

Neuralgia is characterized by chronic pain resulting from damage or diseases in the somatosensory system, including nerves responsible for transmitting sensory information. Current treatments for neuropathic pain, which is a type of neuralgia, have limited success rates and can cause unwanted side effects. Since 1989, botulinum toxin-A (BTX-A), derived from the potent neurotoxin Clostridium botulinum, has been used to treat neuropathic pain in humans. BTX-A has shown analgesic effects by inhibiting the release of neurotransmitters involved in pain transmission. This review aims to evaluate the effectiveness of BTX-A in various types of neuralgia. The research question guiding this review is whether BTX-A is safe and effective in reducing pain in different types of neuralgias. To conduct this review, a literature search was performed using the PubMed, Medline, and PubMed Central databases. The search strategy included relevant keywords related to BTX-A, neuralgia, and neuropathic pain. After screening titles, abstracts, and full texts, a total of 30 articles were included in the review. These studies examined the efficacy of BTX-A in various conditions such as postherpetic neuralgia (PHN), auriculotemporal neuralgia (ATN), occipital neuralgia (ON), leprosy-induced neuropathic pain (LIN), focal painful neuropathies, complex regional pain syndrome (CRPS), trigeminal neuralgia (TN), and neuropathic pain associated with spinal cord injury. However, further research is needed to enhance our understanding of the optimal use of BTX-A in specific neuralgias. It is important to acknowledge the limitations of the included studies. Nevertheless, BTX-A might be considered a viable treatment option for neuralgia.

Botulinum Toxin for Pain Relief in Cancer Patients: A Systematic Review of Randomized Controlled Trials

“…Thus, it is crucial integrating the most effective strategies in cancer pain management aiming at reducing pain intensity and its effect in emotional and psychological sphere. On the other hand, the results of the present work are in line with recent systematic reviews supporting the multidimensional effects of BoNT-A in pain management [16,39].…”

“…The lack of significant improvements in perceived pain observed at 1 month [ES: 0.07 (−0.72, −0.86), p = 0.87] raises doubts about integrating BoNT-A injections in the pain management strategies in cancer pain. Despite these considerations, the lack of significance might reflect the slight number of study available and considering the strong evidence supporting the positive effect of BoNT injection in pain management [ 16 , 39 ], further studies are needed to clarify the role of BoNT in cancer pain.…”

“… Risk of bias of the included studies [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] according to RoBv.2. …”