Botulinum Toxin A for Treatment of Allodynia of Complex Regional Pain Syndrome: A Pilot Study

Safarpour, Delaram; Salardini, Arash; Richardson, D. E.; Jabbari, Bahman

doi:10.1111/j.1526-4637.2010.00897.x

Cited by 36 publications

(25 citation statements)

References 21 publications

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“…Analytically, Ranoux et al 11 investigated analgesic effect of BTX-A in 29 patients with focal painful neuropathies and mechanical allodynia using a randomized, double-blind, placebo-controlled design. 13 With regard to PHN, available data from case series 5,9,10 and randomized controlled trials 11,14,15 uniformly converge to the conclusion that BTX-A has a definite therapeutic benefit in this subgroup of neuropathy patients. Investigators concluded that BTX-A may induce direct analgesic effects in patients with chronic neuropathic pain independent of its effects on muscle tone, suggesting for the first time BTX-A as a novel indications for analgesia.…”

Section: Discussionmentioning

confidence: 97%

Botulinum Toxin A in Postherpetic Neuralgia

Apalla

Sotiriou

Lallas

et al. 2013

The Clinical Journal of Pain

102

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Section: Discussionmentioning

confidence: 97%

Botulinum Toxin A in Postherpetic Neuralgia

Apalla

Sotiriou

Lallas

et al. 2013

The Clinical Journal of Pain

102

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“…Based on one class III study showing negative results [38] in conflict with 1 class III study [39] and two class IV studies [40,41] showing positive results, there is level U (insufficient) evidence for use of BoNT in the management of pain associated with CRPS (Table 6). …”

Section: Complex Regional Pain Syndromementioning

confidence: 93%

“…Safarpour et al performed a randomized, prospective, double-blind, placebo-controlled clinical trial of eight patients with CRPS (six additional patients underwent an open-label protocol) which revealed that onabotulinumtoxinA injections had no improvement in pain and were very poorly tolerated owing to i njection pain [38].…”

Section: Complex Regional Pain Syndromementioning

confidence: 98%

Botulinum Toxin for Neuropathic Pain and Spasticity: An Overview

2014

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In recent years, a large body of data has surfaced reporting the therapeutic benefit of botulinum toxin injection in multiple conditions. The aim of this review is: to summarize the highest quality literature pertaining to clinical application of botulinum toxin in neuropathic pain conditions including postherpetic neuralgia, trigeminal neuralgia, diabetic polyneuropathy, post-traumatic neuralgia, carpal tunnel syndrome, complex regional pain syndrome, phantom limb and stump pain, and occipital neuralgia; to provide an overview of the clinical trials using botulinum toxin in adult spasticity; and to assign levels of evidence according to the American Academy of Neurology guidelines. In summary, there is level A evidence for established efficacy in postherpetic neuralgia and adult spasticity; level B evidence for probable efficacy in trigeminal neuralgia and post-traumatic neuralgia; level B evidence for probable lack of efficacy in carpal tunnel syndrome; level C evidence for possible efficacy in diabetic polyneuropathy; and level U (insufficient) evidence in complex regional pain syndrome, phantom limb and stump pain, and occipital neuralgia.

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“…The efficacy of subcutaneous BoNT-A in relieving allodynia from chronic neuropathic pain led investigators to perform a PC-RCT on subcutaneous BoNT-A in patients with CRPS 285 . BoNT-A was injected at a dose of 5 units per site, half of the dose was injected intradermally while half was injected subcutaneously.…”

Section: Findings From Studies Grouped By Chronic Pain Syndromementioning

confidence: 99%

“…The outcome measures included several questionnaires and quantitative sensory testing. The study had to be stopped after an interim evaluation showed no relief at 3 or 8 weeks after treatment and 8 of 9 patients considered the treatment to be intolerable and stated that they would not consider the injections as treatment for their pain 285 .…”

Section: Findings From Studies Grouped By Chronic Pain Syndromementioning

confidence: 99%

Alternatives to Opioids in the Pharmacologic Management of Chronic Pain Syndromes: A Narrative Review of Randomized, Controlled, and Blinded Clinical Trials

Nicol

Hurley

Benzon

2017

Anesthesia &Amp; Analgesia

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Chronic pain exerts a tremendous burden on individuals and societies. If one views chronic pain as a single disease entity, then it is the most common and costly medical condition. At present, medical professionals who treat patients in chronic pain are recommended to provide comprehensive and multidisciplinary treatments, which may include pharmacotherapy. Many providers employ non-opioid medications to treat chronic pain, however, for some patients, opioid analgesics are the exclusive treatment of chronic pain. However, there is currently an epidemic of opioid use in the United States, and recent guidelines from the Centers for Disease Control (CDC) have recommended that the use of opioids for non-malignant chronic pain be used only in certain circumstances. The goal of this review was to report the current body of evidence-based medicine gained from prospective, randomized-controlled, blinded studies on the use of non-opioid analgesics for the most common non-cancer chronic pain conditions. A total of 9566 studies were obtained during literature searches and 271 of these met inclusion for this review. Overall, while many non-opioid analgesics have been found to be effective in reducing pain for many chronic pain conditions, it is evident that the number of high-quality studies is lacking and the effect sizes noted in many studies is not considered to be clinically significant despite statistical significance. More research is needed to determine effective and mechanisms-based treatments for the chronic pain syndromes discussed in this review. Utilization of rigorous and homogeneous research methodology would likely allow for better consistency and reproducibility, which is of utmost importance in guiding evidence-based care.

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Botulinum Toxin A for Treatment of Allodynia of Complex Regional Pain Syndrome: A Pilot Study

Abstract: Intrademal and subcutaneous administration of BoNT-A into the allodynic skin of the patients with complex regional pain syndrome (CRPS) failed to improve pain and was poorly tolerated.

Cited by 36 publications

References 21 publications

Botulinum Toxin A in Postherpetic Neuralgia

Botulinum Toxin A in Postherpetic Neuralgia

Botulinum Toxin for Neuropathic Pain and Spasticity: An Overview

Alternatives to Opioids in the Pharmacologic Management of Chronic Pain Syndromes: A Narrative Review of Randomized, Controlled, and Blinded Clinical Trials

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