Evidence based medicine in the use of botulinum toxin for back pain
1Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA. bahman.jabbari@yale.edu
Abstract:
Two randomized, prospective studies, one double blind and one open label, longterm evaluated efficacy and safety of Botulinum toxin A (Allergan-Inc) in 31 and 75 patients with chronic low back pain. Both studies used a novel technique imploying 5 level (L1 to L5) injections (40-50 units/level) of BoNT-A into erector spinae muscles. Significant (p < 0.05) improvement of pain intensity, frequency and activities of daily living was noted in 60% and 53% of the patients, respectively. The second study also depicted safety with repeated injections over 14 months of follow up. Botulinum toxin-A should be considered for treatment of low back pain when other modes of treatment fail to improve pain.
Related Concept Videos
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
The binding of dantrolene to the RYR1...
Skeletal Muscle Relaxants: Therapeutic Uses
Botulism
Classification of Skeletal Muscle Relaxants
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
Centrally Acting Muscle Relaxants: Therapeutic Uses
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
Skeletal Muscle Relaxants: Adverse Effects
Unlike...
