Botulinum toxin A and chronic low back pain: a randomized, double-blind study.
OBJECTIVE
To investigate the efficacy of botulinum toxin A in chronic low back pain and associated disabilities.


METHODS
Thirty-one consecutive patients with chronic low back pain who met the inclusion criteria were studied: 15 received 200 units of botulinum toxin type A, 40 units/site at five lumbar paravertebral levels on the side of maximum discomfort, and 16 received normal saline. Each patient's baseline level of pain and degree of disability was documented using the visual analogue scale (VAS) and the Oswestry Low Back Pain Questionnaire (OLBPQ). The authors reevaluated the patients at 3 and 8 weeks (visual analogue scale) and at 8 weeks (OLBPQ).


RESULTS
At 3 weeks, 11 of 15 patients who received botulinum toxin (73.3%) had >50% pain relief vs four of 16 (25%) in the saline group (p = 0.012). At 8 weeks, nine of 15 (60%) in the botulinum toxin group and two of 16 (12.5%) in the saline group had relief (p = 0.009). Repeat OLBPQ at 8 weeks showed improvement in 10 of 15 (66.7%) in the botulinum toxin group vs three of 16 (18.8%) in the saline group (p = 0.011). No patient experienced side effects.


CONCLUSIONS
Paravertebral administration of botulinum toxin A in patients with chronic low back pain relieved pain and improved function at 3 and 8 weeks after treatment.
Foster
L
L
Department of Physical Medicine & Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA.
Clapp
L
L
Erickson
M
M
Jabbari
B
B
D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D010147:Pain Measurement; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D013035:Spasm / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D019274:Botulinum Toxins, Type A