Clinically Significant Placebo Analgesic Response in a Pilot Trial of Botulinum B in Patients with Hand Pain and Carpal Tunnel Syndrome

Breuer, Brenda; Sperber, Kevin; Wallenstein, Sylvan; Kiprovski, Kiril; Calapa, Angela; Snow, Barry R.; Pappagallo, M.

doi:10.1111/j.1526-4637.2006.00084.x

Cited by 39 publications

(53 citation statements)

References 29 publications

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“…The authors found no benefit from injection of rimabotulinumtoxinB on pain, sleep, or quality of life compared with the placebo [35].…”

Section: Review Brown Schütz and Simpsonmentioning

confidence: 96%

“…Bohluli et al published preliminary data of an uncontrolled, nonrandomized, open-label trial of 15 patients with a 6-month to 24-year history of refractory trigeminal neuralgia in which an unspecified preparation of BoNT-A was injected into trigger zones (50-100 U of BoNT-A at each trigger zone with an unspecified depth of injection) identified by patients and confirmed by [35] Tsai et al clinical examination and by response to lidocaine injection. Patients were evaluated at 1 week, 1 month and 6 months following injections.…”

Section: Trigeminal Neuralgiamentioning

confidence: 97%

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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 authors found no benefit from injection of rimabotulinumtoxinB on pain, sleep, or quality of life compared with the placebo [35].…”

Section: Review Brown Schütz and Simpsonmentioning

confidence: 96%

Section: Trigeminal Neuralgiamentioning

confidence: 97%

Botulinum Toxin for Neuropathic Pain and Spasticity: An Overview

2014

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“…These results do not allow us to discriminate the placebo effect that has proved to be significant in similar situations. 9 Our group successfully treated a patient with refractory chronic postthoracotomy pain with subcutaneous BTX-A. 30 We found only 1 case in the literature of chronic postthoracotomy pain with subcutaneous BTX-A.…”

Section: Miscellaneousmentioning

confidence: 96%

“…We found only 1 report of BTX type B used for neuropathic pain. 9 For this reason, our literature search focused on BTX-A.…”

mentioning

confidence: 99%

Subcutaneous and Perineural Botulinum Toxin Type A For Neuropathic Pain

Fabregat-Cid

Andrés

Villanueva-Pérez

et al. 2013

The Clinical Journal of Pain

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“…Tsai found that in five patients injected intracarpally with toxin, pain was better in three, but there was no change in electrophysiological investigations indicating only a placebo or nociceptor response. Breuer et al 65 found no difference in a randomized controlled trial between placebo and botulinum toxin in 20 carpal tunnel patients.…”

Section: Carpal Tunnel Syndromementioning

confidence: 98%

Role of botulinum toxin in hand and upper limb disorders relevant to hand therapy

Keir¹,

Giele²

2009

Hand Therapy

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Introduction. This article reviews the mechanism of action of botulinum toxin and provides an overview of its use in hand disorders relevant to hand therapy such as hyperhidrosis, spasticity, dystonia, tremor, Parkinson's, obstetrical brachial plexus palsy, flexor tendon rehabilitation, lateral epicondylitis, Raynaud's and carpal tunnel syndrome. Methods. A narrative review of the literature retrieved through electronic databases using keywords botulinum toxin, hand, therapy, and reviewing the bibliographic references cited. Results. Sixty-five original articles and meta-analyses were reviewed. The number and quality of the published reports for each disorder are very variable but generally botulinum toxin is reported to be an effective adjunct to therapy in the treatment of a wide variety of hand and upper limb pathologies. Discussion. A surprising number of hand and upper limb conditions have been successively treated with botulinum toxin, but most require botulinum toxin to be used in conjunction with hand therapy to achieve more effective outcomes for longer duration. Neuromuscular disorders seem to be most responsive to botulinum toxin treatment. Therapists should be aware of the potential benefits of botulinum toxin injections for a wide range of hand disorders and when appropriate discuss these with patients and other health professionals. Conclusion. Botulinum toxin has an effective and growing role in hand therapy.

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Clinically Significant Placebo Analgesic Response in a Pilot Trial of Botulinum B in Patients with Hand Pain and Carpal Tunnel Syndrome

Abstract: Botulinum toxin B is not dramatically superior to placebo for the relief of CTS symptoms. Possible explanations of the improvements in each study group are explored.

Cited by 39 publications

References 29 publications

Botulinum Toxin for Neuropathic Pain and Spasticity: An Overview

Botulinum Toxin for Neuropathic Pain and Spasticity: An Overview

Subcutaneous and Perineural Botulinum Toxin Type A For Neuropathic Pain

Role of botulinum toxin in hand and upper limb disorders relevant to hand therapy

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