Botulinum toxin for subacute/chronic neck pain

Langevin, Pierre; Peloso, Paul M.; Lowcock, Janet; Nolan, May; Weber, Jeff; Gross, Anita; Roberts, John; Goldsmith, Charles H.; Graham, Nadine; Burnie, Stephen J; Haines, Ted

doi:10.1002/14651858.cd008626.pub2

Cited by 25 publications

(11 citation statements)

References 128 publications

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“…Our criteria and methodology were consistent with our published protocol for our Cochrane reviews [42, 43] and followed the Cochrane Handbook [44] or PRISMA Guidelines [45]. A protocol specific to this review was not published or registered.…”

Section: Methodsmentioning

confidence: 99%

Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression

Gross¹,

Dziengo²,

Boers³

et al. 2013

Open Orthop J

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Purpose:This systematic review update evaluated low level laser therapy (LLLT) for adults with neck pain.Methods:Computerized searches (root up to Feb 2012) included pain, function/disability, quality of life (QoL) and global perceived effect (GPE). GRADE, effect-sizes, heterogeneity and meta-regression were assessed.Results:Of 17 trials, 10 demonstrated high risk of bias. For chronic neck pain, there was moderate quality evidence (2 trials, 109 participants) supporting LLLT over placebo to improve pain/disability/QoL/GPE up to intermediate-term (IT). For acute radiculopathy, cervical osteoarthritis or acute neck pain, low quality evidence suggested LLLT improves ST pain/function/QoL over a placebo. For chronic myofascial neck pain (5 trials, 188 participants), evidence was conflicting; a meta-regression of heterogeneous trials suggests super-pulsed LLLT increases the chance of a successful pain outcome.Conclusions:We found diverse evidence using LLLT for neck pain. LLLT may be beneficial for chronic neck pain/function/QoL. Larger long-term dosage trials are needed.

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Section: Methodsmentioning

confidence: 99%

Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression

Gross¹,

Dziengo²,

Boers³

et al. 2013

Open Orthop J

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“…Excluded reviews are presented in Appendix 3, along with an accompanying rationale for their exclusion. Using the selected (prioritized) reviews, we report on trial findings by “overall quality of evidence” using the GRADE approach and stratified by the pre-determined treatment category in the Summary of Findings table (Table 2 ) [17-90]. We report on conflicting evidence across reviews in Table 3 [91, 92].…”

Section: Resultsmentioning

confidence: 99%

“…Acetaminophen can be associated with GI events but at a lower rate than that of NSAIDS. Acetaminophen can lead to renal failure however with a RR up to 2.5 (95% CI 1.7, 3.6) [90]. …”

Section: Discussionmentioning

confidence: 99%

Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON Project

Peloso

Khan²,

Gross³

et al. 2013

Open Orthop J

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Objectives:To conduct an overview (review-of-reviews) on pharmacological interventions for neck pain.Search Strategy:Computerized databases and grey literature were searched from 2006 to 2012.Selection Criteria:Systematic reviews of randomized controlled trials (RCT) in adults with acute to chronic neck pain reporting effects of pharmacological interventions including injections on pain, function/disability, global perceived effect, quality of life and patient satisfaction.Data Collection & Analysis:Two independent authors selected articles, assessed risk of bias and extracted data The GRADE tool was used to evaluate the body of evidence and an external panel provided critical review.Main Results:We found 26 reviews reporting on 47 RCTs. Most pharmacological interventions had low to very low quality methodologic evidence with three exceptions. For chronic neck pain, there was evidence of: a small immediate benefit for eperison hydrochloride (moderate GRADE, 1 trial, 157 participants);no short-term pain relieving benefit for botulinum toxin-A compared to saline (strong GRADE; 5 trial meta-analysis, 258 participants) nor for subacute/chronic whiplash (moderate GRADE; 4 trial meta-analysis, 183 participants) including reduced pain, disability or global perceived effect; andno long-term benefit for medial branch block of facet joints with steroids (moderate GRADE; 1 trial, 120 participants) over placebo to reduce pain or disability; Reviewers' Conclusions:While in general there is a lack of evidence for most pharmacological interventions, current evidence is against botulinum toxin-A for chronic neck pain or subacute/chronic whiplash; against medial branch block with steroids for chronic facet joint pain; but in favour of the muscle relaxant eperison hydrochloride for chronic neck pain.

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“…A 2011 systematic review on botolinum toxin (BoNT) for subacute/chronic neck pain was updated [15] (search end date 2010) and the conclusions were consistent with an International Collaboration on Neck (ICON) overview of systematic reviews on medicines and injections for neck pain [16] in suggesting that there is evidence against the use of BoNT-A for chronic neck pain or subacute/chronic whiplash. Further the ICON review of systematic reviews gave evidence against medial branch block with steroids for chronic facet joint pain, but for the use of eperison hydrochloride for chronic neck pain.…”

Section: Introductionmentioning

confidence: 90%

“…The above inclusion and exclusion criteria are based on criteria used by the Cervical Overview Group (COG) in the systematic review on BoNT for subacute/chronic neck pain update [15]. …”

Section: Criteria For Considering Studies For This Reviewmentioning

confidence: 99%

Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

Gross

Peloso²,

Galway³

et al. 2013

TOORTHJ

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Background: Controversy persists regarding medicinal injections for mechanical neck disorders (MNDs).Objectives: To determine the effectiveness of physician-delivered injections on pain, function/disability, quality of life, global perceived effect and patient satisfaction for adults with MNDs.Search Methods: We updated our previous searches of CENTRAL, MEDLINE and EMBASE from December 2006 through to March 2012.Selection Criteria: We included randomized controlled trials of adults with neck disorders treated by physician-delivered injection therapies.Data Collection and Analysis: Two authors independently selected articles, abstracted data and assessed methodological quality. When clinical heterogeneity was absent, we combined studies using random-effects models.Results: We included 12 trials (667 participants). No high or moderate quality studies were found with evidence of benefit over control. Moderate quality evidence suggests little or no difference in pain or function/disability between nerve block injection of steroid and bupivacaine vs bupivacaine alone at short, intermediate and long-term for chronic neck pain. We found limited very low quality evidence of an effect on pain with intramuscular lidocaine vs control for chronic myofascial neck pain. Two low quality studies showed an effect on pain with anaesthetic nerve block vs saline immediately post treatment and in the short-term. All other studies were of low or very low quality with no evidence of benefit over controls.Authors' Conclusions: Current evidence does not confirm the effectiveness of IM-lidocaine injection for chronic mechanical neck pain nor anaesthetic nerve block for cervicogenic headache. There is moderate evidence of no benefit for steroid blocks vs controls for mechanical neck pain.

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Botulinum toxin for subacute/chronic neck pain

Cited by 25 publications

References 128 publications

Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression

Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression

Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON Project

Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

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