Clinical Effectiveness of Botulinum Toxin A Compared to a Mixture of Steroid and Local Anesthetics as a Treatment for Sacroiliac Joint Pain

Lee, Jung H.; Lee, Sang-Ho; Song, Sun Hong

doi:10.1111/j.1526-4637.2010.00838.x

Cited by 27 publications

(25 citation statements)

References 43 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar results have been reported in human patients with arthritis [31–34], and in induced inflammatory arthritis in experimental horses and mice [31, 35]. Despite these promising results, the mechanism of the antinociceptive action of the toxin inside the joint has not been previously investigated.…”

Section: Introductionsupporting

confidence: 67%

The effect of intra-articular botulinum toxin A on substance P, prostaglandin E2, and tumor necrosis factor alpha in the canine osteoarthritic joint

et al. 2017

View full text Add to dashboard Cite

BackgroundRecently, intra-articular botulinum toxin A (IA BoNT A) has been shown to reduce joint pain in osteoarthritic dogs. Similar results have been reported in human patients with arthritis. However, the mechanism of the antinociceptive action of IA BoNT A is currently not known. The aim of this study was to explore this mechanism of action by investigating the effect of IA BoNT A on synovial fluid (SF) and serum substance P (SP), prostaglandin E2 (PGE2), and tumor necrosis factor alpha (TNF-α) in osteoarthritic dogs. Additionally, the aim was to compare SF SP and PGE2 between osteoarthritic and non-osteoarthritic joints, and investigate associations between SP, PGE2, osteoarthritic pain, and the signalment of dogs. Thirty-five dogs with chronic naturally occurring osteoarthritis and 13 non-osteoarthritic control dogs were included in the study. Osteoarthritic dogs received either IA BoNT A (n = 19) or IA placebo (n = 16). Serum and SF samples were collected and osteoarthritic pain was evaluated before (baseline) and 2 and 8 weeks after treatment. Osteoarthritic pain was assessed with force platform, Helsinki Chronic Pain Index, and joint palpation. Synovial fluid samples were obtained from control dogs after euthanasia. The change from baseline in SP and PGE2 concentration was compared between the IA BoNT A and placebo groups. The synovial fluid SP and PGE2 concentration was compared between osteoarthritic and control joints. Associations between SP, PGE2, osteoarthritic pain, and the signalment of dogs were evaluated.ResultsThere was no significant change from baseline in SP or PGE2 after IA BoNT A. Synovial fluid PGE2 was significantly higher in osteoarthritic compared to control joints. Synovial fluid PGE2 correlated with osteoarthritic pain. No associations were found between SP or PGE2 and the signalment of dogs. The concentration of TNF-α remained under the detection limit of the assay in all samples.ConclusionsThe results suggest that the antinociceptive effect of IA BoNT A in the joint might not be related to the inhibition of SP nor PGE2. Synovial fluid PGE2, but not SP, could be a marker for chronic osteoarthritis and pain in dogs.

show abstract

Section: Introductionsupporting

confidence: 67%

The effect of intra-articular botulinum toxin A on substance P, prostaglandin E2, and tumor necrosis factor alpha in the canine osteoarthritic joint

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Five studies evaluated injection therapy for sacroiliac joint pain using corticosteroid, Botulinum toxin, or prolotherapy 9,10,11,12,13. Three of the injection studies were comparative studies; however, these are considered case series (CoE IV) for this review, with each treatment arm considered separately 9,11,12…”

Section: Resultsmentioning

confidence: 99%

“…CoE indicates class of evidence; CT, computed tomography; MRI, magnetic resonance imaging; NR, not reported; FU, follow-up; SIJ, sacroiliac joint; OA, osteoarthritis; IA, inflammatory arthritis; LBP, low back pain; P2G, phenol, glycerine, glucose; BT, Botulinum toxin type A; NRS, numeric rating scale for pain; MMPI, Minnesota Multiphasic Personality Inventory; FPI, Freiburg personality inventory; FAPK, questionnaire for recognition of psychosomatic diseases; ICBG, iliac crest bone graft. Although these studies were designed to compare injection treatments, for the purpose of this review they are considered case series, with each arm addressed separately, since the study question focuses on comparing surgery with injection 9,11,12†

Demographics applicable to patients analyzed;11 patients completing all discharge questionnaires;13 and patients before diagnostic block performed (n = 118 patients had positive diagnostic block and were included in study) 10.

…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Surgical versus injection treatment for injection-confirmed chronic sacroiliac joint pain

Spiker

Lawrence

Raich

et al. 2013

Evidence-Based Spine-Care Journal

View full text Add to dashboard Cite

Study design: Systematic review.Study rationale: Chronic sacroiliac joint pain (CSJP) is a common clinical entity with highly controversial treatment options. A recent systematic review compared surgery with denervation, but the current systematic review compares outcomes of surgical intervention with therapeutic injection for the treatment of CSJP and serves as the next step for evaluating current evidence on the comparative effectiveness of treatments for non-traumatic sacroiliac joint pain.Objective or clinical question: In adult patients with injection-confirmed CSJP, does surgical treatment lead to better outcomes and fewer complications than injection therapy?Methods: A systematic review of the English-language literature was undertaken for articles published between 1970 and June 2012. Electronic databases and reference lists of key articles were searched to identify studies evaluating surgery or injection treatment for injection-confirmed CSJP. Studies involving traumatic onset or non-injection–confirmed CSJP were excluded. Two independent reviewers assessed the level of evidence quality using the grading of recommendations assessment, development and evaluation (GRADE) system, and disagreements were resolved by consensus.Results: We identified twelve articles (seven surgical and five injection treatment) meeting our inclusion criteria. Regardless of the type of treatment, most studies reported over 40% improvement in pain as measured by Visual Analog Scale or Numeric rating Scale score. Regardless of the type of treatment, most studies reported over 20% improvement in functionality. Most complications were reported in the surgical studies.Conclusion: Surgical fusion and therapeutic injections can likely provide pain relief, improve quality of life, and improve work status. The comparative effectiveness of these interventions cannot be evaluated with the current literature.

show abstract

“…The role of SIJ in the genesis of clinically-relevant alterations is often under-estimated and the methodologically correct approach for diagnosis of SIJ involvement is still uncertain and the object of debate for several reasons; recent studies suggest that anesthetic injections for pain blocking may be useful for a correct diagnosis and definition of the role of SIJ in the genesis of pain, even more than common imaging, thus suggesting how local approaches to SIJ are not only necessary as therapy in certain cases, but also fundamental for diagnosis 2 . In seronegative spondiloarthritides, where SIJ inflammatory involvement is common 3 , a systemic approach by the use of immunosuppressants or biologic drugs is usually sufficient to control the SIJ inflammation and its clinical manifestations, as well as the systemic involvement of other joints and eventual organs or apparatuses 4 .…”

Section: I a L D I S T R I B U T I O N U N A U T H O R I Z E D U S mentioning

confidence: 99%

Local approaches to sacro-iliac joint pathologies: several unanswered questions

Bizzi

Migliore

2013

Current Medical Research and Opinion

View full text Add to dashboard Cite

Clinical Effectiveness of Botulinum Toxin A Compared to a Mixture of Steroid and Local Anesthetics as a Treatment for Sacroiliac Joint Pain

Abstract: BT shows clinical usefulness in pain reduction and for functional improvement in patients with SIJ pain. This effect was maintained for 3 months following the injection, by which time the effects of TA had diminished.

Cited by 27 publications

References 43 publications

The effect of intra-articular botulinum toxin A on substance P, prostaglandin E2, and tumor necrosis factor alpha in the canine osteoarthritic joint

The effect of intra-articular botulinum toxin A on substance P, prostaglandin E2, and tumor necrosis factor alpha in the canine osteoarthritic joint

Surgical versus injection treatment for injection-confirmed chronic sacroiliac joint pain

Local approaches to sacro-iliac joint pathologies: several unanswered questions

Contact Info

Product

Resources

About