Botulinum neurotoxin type A for the treatment of pain: not just in migraine and trigeminal neuralgia.
BACKGROUND
Despite their huge epidemiological impact, primary headaches, trigeminal neuralgia and other chronic pain conditions still receive suboptimal medical approach, even in developed countries. The limited efficacy of current pain-killers and prophylactic treatments stands among the main reasons for this phenomenon. Botulinum neurotoxin (BoNT) represents a well-established and licensed treatment for chronic migraine, but also an emerging treatment for other types of primary headache, trigeminal neuralgia, neuropathic pain, and an increasing number of pain conditions.


METHODS
We searched and critically reviewed evidence for the efficacy of BoNT for the treatment of chronic pain.


RESULTS
Meta-analyses and randomized controlled trials (RCTs) suggest that BoNT potentially represents a multi-purpose drug for the treatment of pain in several disorders due to a favorable safety profile and a long-lasting relief after a single injection.


CONCLUSIONS
BoNT is an emerging treatment in different pain conditions. Future RCTs should explore the use of BoNT injection therapy combined with systemic drugs and/or physical therapies as new pain treatment strategies.
C. Mondino National Institute of Neurology Foundation, IRCCS, Pavia, Italy.|Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
Giorgio
G
Sandrini
C. Mondino National Institute of Neurology Foundation, IRCCS, Pavia, Italy.|Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
Roberto
R
De Icco
C. Mondino National Institute of Neurology Foundation, IRCCS, Pavia, Italy.|Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
Cristina
C
Tassorelli
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, I-37134, Verona, Italy.|Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
Nicola
N
Smania
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, I-37134, Verona, Italy. stefano.tamburin@univr.it.
Stefano
http://orcid.org/0000-0002-1561-2187
S
Tamburin
D000700:Analgesics / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D015201:Meta-Analysis as Topic; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy*; D009437:Neuralgia / Q000175:diagnosis / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000175:diagnosis / Q000188:drug therapy*
D000700:Analgesics; D019274:Botulinum Toxins, Type A
Botulinum neurotoxin; Migraine; Neuropathic pain; Pain; Primary headaches; Treatment; Trigeminal neuralgia