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The analgesic effect of botulinum-toxin A on postwhiplash neck pain.
Clin J Pain. 2008 Jan; 24(1):5-10.CJ

Abstract

BACKGROUND

The effectiveness of botulinum neurotoxin type A (BTXA) injections in relieving the neck pain and reduced motion that evolve after whiplash injury (WI) has been controversial.

AIM OF STUDY

To test the long-term efficacy of a tender point injection of BTXA in relieving neck pain in patients with WI.

METHODS

Twenty patients with cervical myofascial pain, 2 to 48 weeks after WI, were randomly assigned to receive either 200 U of BTXA or placebo at 4 tender points and were seen during the follow-ups 3, 6, 9, 12, and 24 weeks after the injections. Outcome measures included the intensity of pain as evaluated by a 10-cm Visual Analog Scale (VAS) and a 5-point Verbal Rating Scale (VRS), quality of life as evaluated by the SF-36 questionnaire, treatment efficacy as per the global assessment of the physician and patient, intensity of pain in response to mechanical pressure, range of cervical motion, and use of other therapies and their adverse effects.

RESULTS

A time-dependent improvement in all the parameters was found in both groups, which was consistently larger in the BTXA-treated group, but mostly not at a significant level. Significant differences between the groups were found only in the percentages of patients who achieved 50% or more of reduction in intensity (VAS and average VRS) at 24 weeks (50% vs. 0%, P>0.05 and 70% vs. 11%, P>0.05, respectively). Systemic adverse effects tended to be more common in the BTXA-treated group (40% vs. 0%, P=0.07).

CONCLUSIONS

Study results suggest that BTXA treatment has some efficacy when administered within 1 year of the WI. However, a large, well-designed clinical trial is needed to draw final conclusions.

Authors+Show Affiliations

Pain Relief Unit, Rambam Medical Center, Haifa, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18180629

Citation

Braker, Clara, et al. "The Analgesic Effect of Botulinum-toxin a On Postwhiplash Neck Pain." The Clinical Journal of Pain, vol. 24, no. 1, 2008, pp. 5-10.
Braker C, Yariv S, Adler R, et al. The analgesic effect of botulinum-toxin A on postwhiplash neck pain. Clin J Pain. 2008;24(1):5-10.
Braker, C., Yariv, S., Adler, R., Badarny, S., & Eisenberg, E. (2008). The analgesic effect of botulinum-toxin A on postwhiplash neck pain. The Clinical Journal of Pain, 24(1), 5-10. https://doi.org/10.1097/AJP.0b013e318156d90c
Braker C, et al. The Analgesic Effect of Botulinum-toxin a On Postwhiplash Neck Pain. Clin J Pain. 2008;24(1):5-10. PubMed PMID: 18180629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The analgesic effect of botulinum-toxin A on postwhiplash neck pain. AU - Braker,Clara, AU - Yariv,Shahak, AU - Adler,Rivka, AU - Badarny,Samih, AU - Eisenberg,Elon, PY - 2008/1/9/pubmed PY - 2008/2/21/medline PY - 2008/1/9/entrez SP - 5 EP - 10 JF - The Clinical journal of pain JO - Clin J Pain VL - 24 IS - 1 N2 - BACKGROUND: The effectiveness of botulinum neurotoxin type A (BTXA) injections in relieving the neck pain and reduced motion that evolve after whiplash injury (WI) has been controversial. AIM OF STUDY: To test the long-term efficacy of a tender point injection of BTXA in relieving neck pain in patients with WI. METHODS: Twenty patients with cervical myofascial pain, 2 to 48 weeks after WI, were randomly assigned to receive either 200 U of BTXA or placebo at 4 tender points and were seen during the follow-ups 3, 6, 9, 12, and 24 weeks after the injections. Outcome measures included the intensity of pain as evaluated by a 10-cm Visual Analog Scale (VAS) and a 5-point Verbal Rating Scale (VRS), quality of life as evaluated by the SF-36 questionnaire, treatment efficacy as per the global assessment of the physician and patient, intensity of pain in response to mechanical pressure, range of cervical motion, and use of other therapies and their adverse effects. RESULTS: A time-dependent improvement in all the parameters was found in both groups, which was consistently larger in the BTXA-treated group, but mostly not at a significant level. Significant differences between the groups were found only in the percentages of patients who achieved 50% or more of reduction in intensity (VAS and average VRS) at 24 weeks (50% vs. 0%, P>0.05 and 70% vs. 11%, P>0.05, respectively). Systemic adverse effects tended to be more common in the BTXA-treated group (40% vs. 0%, P=0.07). CONCLUSIONS: Study results suggest that BTXA treatment has some efficacy when administered within 1 year of the WI. However, a large, well-designed clinical trial is needed to draw final conclusions. SN - 0749-8047 UR - https://www.unboundmedicine.com/medline/citation/18180629/The_analgesic_effect_of_botulinum_toxin_A_on_postwhiplash_neck_pain_ L2 - https://doi.org/10.1097/AJP.0b013e318156d90c DB - PRIME DP - Unbound Medicine ER -