The Use of Botulinum Toxin-A for Neck Pain
Recently, there was an interest in utilizing it for muscular
neck pain and headache.
These conditions can be chronic and difficult to treat.
Although there are more consensus on
migraine and cervical dystonia, the literature showed
conflicting results and conclusions.
A randomized double-blinded study showed
a trend toward improvement in the BOTOX® group.
Another prospective study showed a significant reduction
of pain intensity in patients receiving
BoNT-A for refractory neck pain.
One more randomized controlled study for chronic neck pain after “whiplash” injuries
were demonstrated a statistically significant reduction in pain for the patients who were treated
with BoNT-A compared with placebo.
Contradicting results were found on other studies where the injected
BoNT-A failed to provide significant improvement of neck pain.
In a randomized, double-blinded study, injection of BoNT-A
were directly triggered to the points did not improve cervicothoracic myofascial pain.
Although many studies have shown it to be safe, the adverse effects remains
a concern among physicians using these injections.
The role of direct injection of trigger points with BoNT-A for neck pain and spasm is
still under progressive research and study.
There could be a beneficial role for BoNT-A as an alternative treatment for resistant cases with chronic
pain refractory to other modalities.
Now a-days, the clinical practice should follow evidence based medicine. A clear protocol including
the type of toxin injected, suggested dose, concentration, and methods of injection should be
established.
Recently, there was an interest in utilizing it for muscular neck pain and headache.
These conditions can be chronic and difficult to treat. Although there are more consensus on
migraine and cervical dystonia, the literature showed conflicting results and conclusions.
Osteol Rheumatol Open J. 2016; 1(1): 4-5. doi: 10.17140/ORHOJ-1-102