Botulinum Toxin in Pain Treatment

Abstract

Botulinum toxin type A is well tolerated in the treatment of chronic pain disorders in which pharmacotherapy regimens can cause side effects. The reduction in the consumption of analgesics and length of action of 3 to 4 months per dose represent other advantages of its use. However, further studies are necessary to establish the efficacy of BTX-A in chronic pain disorders and its exact mechanism of action, as well as its potential in multifactorial treatments.

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

“…Subcutaneous BoNTA administration to the paws of mice significantly reduced the inflammatory response induced by subcutaneous formalin, which has an analgesic effect by blocking glutamate release from peripheral axons. Moreover, reduced activity was observed in dorsal root neurons in the spinal cord (34). The direct inhibitory effect of BoNTA on nociceptors due to inhibition of neuropeptide release might be responsible for central or peripheral pain pathway sensitization and neurotransmission.…”

“…Protective (immune) resistance develops in response to long-term use (33). It was reported that BoNTA is associated with substance P release from neuronal cell cultures obtained from dorsal root ganglia of mouse embryos and CGRP release from neuronal cell cultures obtained from trigeminal ganglia (34). Subcutaneous BoNTA administration to the paws of mice significantly reduced the inflammatory response induced by subcutaneous formalin, which has an analgesic effect by blocking glutamate release from peripheral axons.…”

“…The direct inhibitory effect of BoNTA on nociceptors due to inhibition of neuropeptide release might be responsible for central or peripheral pain pathway sensitization and neurotransmission. In addition to being a potent inhibitor of acetylcholine release, as BoNTA inhibits neurotransmitters and neuropeptides, it has anti-inflammatory and analgesic effects (34).…”

Toxina Botulínica para el Tratamiento de los Desórdenes Temporomandibulares

“…La inyección intramuscular en dosis y localización apropiada, provoca denervación química parcial y disminución de la contractura, sin ocasionar parálisis completa (Clark, 2003;Ho & Tan;Colhado et al) a lo que se le atribuye ser un innovador y eficaz método de tratamiento para el dolor crónico asociada con hiperactividad de los músculos masticatorios (von Lindern).…”

“…Solo la toxina A y B son utilizadas en la práctica clínica después de la aprobación de la Food and Drug Administration (FDA) en 1989 y 2000; actualmente continuan siendo utilizadas para tratar varias condiciones de dolor, incluyendo la espasticidad muscular, distonia, dolor de cabeza y dolor miofascial (Colhado et al, 2009).…”