Injection Botulinum Toxin A in Treatment of Resistant Chronic Low Back Pain: A Prospective Open-Label Study

Sahoo, Jagannatha; Jena, Debasish; Viswanath, Amrutha; Barman, Apurba

doi:10.7759/cureus.17811

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…Moreover, BTX-A injections demonstrated better effects in the treatment of chronic low back pain compared with saline injections, a combination of lidocaine and corticosteroids, and traditional acupuncture [ 173 ]. In a recent prospective open-label study, BTX-A injection significantly improved pain scores measured in patients with resistant chronic low back pain with mild transient complications in a minority of patients [ 128 ]. The above findings should be confirmed by well-designed studies with a larger sample size.…”

Section: Treatment Strategies For Neuropathic Painmentioning

confidence: 99%

Diagnosis and Management of Neuropathic Pain in Spine Diseases

Bielewicz

Kamieniak

Szymoniuk

et al. 2023

JCM

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Neuropathic pain is generally defined as a non-physiological pain experience caused by damage to the nervous system. It can occur spontaneously, as a reaction to a given stimulus, or independently of its action, leading to unusual pain sensations usually referred to as firing, burning or throbbing. In the course of spine disorders, pain symptoms commonly occur. According to available epidemiological studies, a neuropathic component of pain is often present in patients with spinal diseases, with a frequency ranging from 36% to 55% of patients. Distinguishing between chronic nociceptive pain and neuropathic pain very often remains a challenge. Consequently, neuropathic pain is often underdiagnosed in patients with spinal diseases. In reference to current guidelines for the treatment of neuropathic pain, gabapentin, serotonin and norepinephrine reuptake inhibitors and tricyclic antidepressants constitute first-line therapeutic agents. However, long-term pharmacologic treatment often leads to developing tolerance and resistance to used medications. Therefore, in recent years, a plethora of therapeutic methods for neuropathic pain have been developed and investigated to improve clinical outcomes. In this review, we briefly summarized current knowledge about the pathophysiology and diagnosis of neuropathic pain. Moreover, we described the most effective treatment approaches for neuropathic pain and discussed their relevance in the treatment of spinal pain.

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Section: Treatment Strategies For Neuropathic Painmentioning

confidence: 99%

Diagnosis and Management of Neuropathic Pain in Spine Diseases

Bielewicz

Kamieniak

Szymoniuk

et al. 2023

JCM

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Pain Disorders other than Migraine

Jabbari

2024

Botulinum Toxin Treatment

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Botulinum toxin type A for treating chronic low back pain: A double blinded randomized control study

Jain,

Khan,

Varghese

et al. 2024

World J Methodol

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BACKGROUND Low back pain (LBP) is a prevalent issue that orthopedic surgeons frequently address in the outpatient setting. LBP can arise from various causes, with stiffness in the paraspinal muscles being a notable contributor. The administration of Botulinum toxin type A (BoNT-A) has been found to alleviate back pain by relaxing these stiff muscles. While BoNT-A is approved for use in numerous conditions, a limited number of randomized clinical trials (RCTs) validate its efficacy specifically for treating LBP. AIM To study the safety and the efficacy of BoNT-A in minimizing pain and improving functional outcomes in patients of chronic LBP (CLBP). METHODS In this RCT, adults aged 18-60 years with mechanical LBP persisting for at least six months were enrolled. Participants were allocated to either the Drug group, receiving 200 Ipsen Units (2 mL) of BoNT-A, or the Control group, which received a 2 mL placebo. Over a 2-month follow-up period, both groups were assessed using the Visual Analog Scale (VAS) for pain intensity and the Oswestry Disability Index (ODI) for disability at the start and conclusion of the study. A decrease in pain by 50% was deemed clinically significant. RESULTS The study followed 40 patients for two months, with 20 in each group. A clinically significant reduction in pain was observed in 36 participants. There was a statistically significant decrease in both VAS and ODI scores in the groups at the end of two months. Nonetheless, when comparing the mean score changes, only the reduction in ODI scores (15 in the placebo group vs 16.5 in the drug group, clinically insignificant) was statistically significant (P = 0.012), whereas the change in mean VAS scores was not significant (P = 0.45). CONCLUSION The study concludes that BoNT-A does not offer a short-term advantage over placebo in reducing pain or improving LBP scores in CLBP patients.

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Injection Botulinum Toxin A in Treatment of Resistant Chronic Low Back Pain: A Prospective Open-Label Study

Cited by 3 publications

References 23 publications

Diagnosis and Management of Neuropathic Pain in Spine Diseases

Diagnosis and Management of Neuropathic Pain in Spine Diseases

Pain Disorders other than Migraine

Botulinum toxin type A for treating chronic low back pain: A double blinded randomized control study

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