Physical therapy and adjunctive botulinum toxin type A in the treatment of cervical headache: a double-blind, randomised, placebo-controlled study

Schnider, Peter; Moraru, E.; Vigl, Marion; Wöber, Christian; Földy, Daniela; Maly, Joachim; Bittner, Christian; Wessely, P; Auff, Eduard

doi:10.1007/s101940200024

Cited by 26 publications

(21 citation statements)

References 13 publications

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“…One study [18] showed a significant improvement in terms of VAS and range of movement; however, there was a significant difference in pre-injection levels (baseline VAS: score saline: 3; baseline VAS score BoNT/A: 6.5). In the other trial BoNT/A was given as add-on to physical therapy [26]. Although headache severity, headache-free days and headache hours improved significantly in both groups, only a trend in favor of BoNT/A was observable.…”

Section: ■ Cervicogenic Headachementioning

confidence: 86%

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Botulinum toxin in the treatment of rare head and neck pain syndromes: a systematic review of the literature

Sycha

Kranz

Auff

et al. 2004

Journal of Neurology

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There is convincing evidence for the effectiveness of BoNT in the treatment of pain associated with cervical dystonia. Due to the frequent adverse effects predominantly observed with higher doses, the trade off in risk and benefit should be carefully considered in each case. For all other rare head and neck pain syndromes we found no RCTs (cluster headache, chronic paroxysmal hemicrania, trigeminal neuralgia) and only a few small sized trials (cervicogenic headache, chronic neck pain, temporomandibular disorders). We were therefore unable to draw any definite conclusions.

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Section: ■ Cervicogenic Headachementioning

confidence: 86%

“…This difference was reported to be significant. Schnider [26] studied 33 patients with cervicogenic headache according to the IHS criteria. Ninety MU Botox® or saline were injected in addition to standardized physical therapy.…”

Section: ■ Cervicogenic Headachementioning

confidence: 99%

Botulinum toxin in the treatment of rare head and neck pain syndromes: a systematic review of the literature

Sycha

Kranz

Auff

et al. 2004

Journal of Neurology

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“…However, there are only a few case reports on BoNTA treatment for cluster headache, and overall the results have been inconsistent (32). Despite the fact that in Schnider et al's randomized, double-blind placebo-controlled study there was no significant difference in the severity of pain between the BoNTA and placebo groups, the duration of pain in the BoNTA group decreased (31).…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Botulinum Toxin in Patients with Cervicogenic Headache: a Placebo-Controlled Clinical Trial

Karadaş¹,

Öztürk²,

Ulaş³

et al. 2012

Balkan Med J

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“…Botulinum toxin-A versus placebo for chronic cervicogenic headache pain (2 trials 58 participants [53, 54] and disability (1 trial [53]) at short-term and 1 trial [53] at intermediate-term follow-up. Additionally botulinum toxin-A versus placebo (saline) (1 trial [55], 45 participants) was not beneficial in improving disability or global perceived effect for chronic myofascial neck and shoulder pain at intermediate-term follow-up.…”

Section: Evidence Of No Benefitmentioning

confidence: 99%

Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON Project

Peloso

Khan²,

Gross³

et al. 2013

Open Orthop J

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Objectives:To conduct an overview (review-of-reviews) on pharmacological interventions for neck pain.Search Strategy:Computerized databases and grey literature were searched from 2006 to 2012.Selection Criteria:Systematic reviews of randomized controlled trials (RCT) in adults with acute to chronic neck pain reporting effects of pharmacological interventions including injections on pain, function/disability, global perceived effect, quality of life and patient satisfaction.Data Collection & Analysis:Two independent authors selected articles, assessed risk of bias and extracted data The GRADE tool was used to evaluate the body of evidence and an external panel provided critical review.Main Results:We found 26 reviews reporting on 47 RCTs. Most pharmacological interventions had low to very low quality methodologic evidence with three exceptions. For chronic neck pain, there was evidence of: a small immediate benefit for eperison hydrochloride (moderate GRADE, 1 trial, 157 participants);no short-term pain relieving benefit for botulinum toxin-A compared to saline (strong GRADE; 5 trial meta-analysis, 258 participants) nor for subacute/chronic whiplash (moderate GRADE; 4 trial meta-analysis, 183 participants) including reduced pain, disability or global perceived effect; andno long-term benefit for medial branch block of facet joints with steroids (moderate GRADE; 1 trial, 120 participants) over placebo to reduce pain or disability; Reviewers' Conclusions:While in general there is a lack of evidence for most pharmacological interventions, current evidence is against botulinum toxin-A for chronic neck pain or subacute/chronic whiplash; against medial branch block with steroids for chronic facet joint pain; but in favour of the muscle relaxant eperison hydrochloride for chronic neck pain.

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Physical therapy and adjunctive botulinum toxin type A in the treatment of cervical headache: a double-blind, randomised, placebo-controlled study

Cited by 26 publications

References 13 publications

Botulinum toxin in the treatment of rare head and neck pain syndromes: a systematic review of the literature

Botulinum toxin in the treatment of rare head and neck pain syndromes: a systematic review of the literature

The Efficacy of Botulinum Toxin in Patients with Cervicogenic Headache: a Placebo-Controlled Clinical Trial

Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON Project

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