Efficacy of Intra-Articular Botulinum Toxin in Osteoarticular Joint Pain

Courseau, Mathilde; Salle, Pascale Vergne; Ranoux, Daniéle; Lachatre, Anais de Pouilly

doi:10.1097/ajp.0000000000000538

Cited by 16 publications

(8 citation statements)

References 32 publications

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“…Meta-analyses and systematic reviews have been published, summarizing these results [24,[30][31][32][33]. A meta-analysis of six randomized controlled trials using IA BoNT for osteoarticular pain, found a statistically significant, short-term one point decrease of a numerical rating scale (NRS) pain score, and a decrease at 6 mo that was not statistically significant [34]. An earlier meta-analysis, which included some of the same studies, found similar results [33].…”

Section: Clinical Use Of Botulinum Toxin For Arthritis Painmentioning

confidence: 90%

The Use of Botulinum Toxin for the Treatment of Chronic Joint Pain: Clinical and Experimental Evidence

Blanshan

Krug

2020

Toxins

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Chronic osteoarthritis pain is an increasing worldwide problem. Treatment for osteoarthritis pain is generally inadequate or fraught with potential toxicities. Botulinum toxins (BoNTs) are potent inhibitors of neuropeptide release. Paralytic toxicity is due to inhibition at the neuromuscular junction, and this effect has been utilized for treatments of painful dystonias. Pain relief following BoNT muscle injection has been noted to be more significant than muscle weakness and hypothesized to occur because of the inhibition of peripheral neuropeptide release and reduction of peripheral sensitization. Because of this observation, BoNT has been studied as an intra-articular (IA) analgesic for chronic joint pain. In clinical trials, BoNT appears to be effective for nociceptive joint pain. No toxicity has been reported. In preclinical models of joint pain, BoNT is similarly effective. Examination of the dorsal root ganglion (DRG) and the central nervous system has shown that catalytically active BoNT is retrogradely transported by neurons and then transcytosed to afferent synapses in the brain. This suggests that pain relief may also be due to the central effects of the drug. In summary, BoNT appears to be safe and effective for the treatment of chronic joint pain. The long-term effects of IA BoNT are still being determined.

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Section: Clinical Use Of Botulinum Toxin For Arthritis Painmentioning

confidence: 90%

The Use of Botulinum Toxin for the Treatment of Chronic Joint Pain: Clinical and Experimental Evidence

Blanshan

Krug

2020

Toxins

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“…114,145 Botulinum modulates neurogenic inflammation and reduces nociceptive stimulation. 146 Although animal studies suggested a potential effectiveness of botulinum on chronic pain associated with OA, 147 its effectiveness in patients with OA of the knee is not supported by strong scientific evidence. Indeed, in several studies botulinum does not differ from sham therapy.…”

Section: Discussionmentioning

confidence: 99%

Osteoarthritis of the Knee in Middle-age Athletes: Many Measures are Practiced, but Lack Sound Scientific Evidence

Quaranta

Riccio

Oliva

et al. 2022

Sports Medicine and Arthroscopy Review

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Osteoarthritis of the knee generally affects individuals from the fifth decade, the typical age of middle-age athletes. In the early stages, management is conservative and multidisciplinary. It is advisable to avoid sports with high risk of trauma, but it is important that patients continue to be physically active. Conservative management offers several options; however, it is unclear which ones are really useful. This narrative review briefly reports the conservative options for which there is no evidence of effectiveness, or there is only evidence of short-term effectiveness.

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“…Courseau 32 in a systematic review and meta-analysis evaluated the efficacy of intra-articular injections of botulinum toxin A (produced by the anaerobic bacterium Clostridium Botulinum) in patients affected by painful osteoarthritis. Although many studies indicate that the botulinum toxin can reduce pain through the reduction of peripheral and central sensitization, in this meta-analysis no significant improvement was found in patients affected by hip or knee OA.…”

Section: Botulinum Toxin Type Amentioning

confidence: 99%

Injection therapy in hip osteoarthritis: one year in review

Souza¹,

Sinelli²,

Lucia³

2020

Beyond Rheumatol

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Hip osteoarthritis affects a substantial and growing number of people worldwide. Its incidence and prevalence are increasing due to ageing and obesity. It is estimated that it affects between 10 and 18% of individuals over 60 years of age and up to 1 in 3 patients over the age of 85 with a substantial proportion of them experiencing persistent pain, loss of function and decline in health-related quality of life. Our work was aimed at updating the latest data on this field. We searched the following terms on PubMed: ‘injection therapy’, ‘osteoarthritis’ and ‘hip’. We limited our search to the period from 1-1-2018 until 22-6-2019 and to the English language. We retrieved 31 works. We decided to divide the works into three groups: hyaluronic acid in hip OA, other therapies in hip OA and emerging radiological techniques to measure the efficacy of injection therapy. So far, in the literature there is no solid evidence that supports the efficacy of intra-articular infiltration therapies in hip osteoarthritis. The international guidelines reflect this lack of solid scientific evidence. We believe that only original works that show high-level evidence can highlight the benefits of these therapies.

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Efficacy of Intra-Articular Botulinum Toxin in Osteoarticular Joint Pain

Abstract: BT-A intra-articular injections have short-term benefits with a statistically significant decrease in the NRS pain score of around 1 point in patients with refractory joint pain. A decrease in the pain score was also observed at 6 months but with a nonsignificant result.

Cited by 16 publications

References 32 publications

The Use of Botulinum Toxin for the Treatment of Chronic Joint Pain: Clinical and Experimental Evidence

The Use of Botulinum Toxin for the Treatment of Chronic Joint Pain: Clinical and Experimental Evidence

Osteoarthritis of the Knee in Middle-age Athletes: Many Measures are Practiced, but Lack Sound Scientific Evidence

Injection therapy in hip osteoarthritis: one year in review

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