Intramuscular botulinum toxin a (BTXA) in complex regional pain syndrome

Siddharth Kharkar, Prakash Ambady, Venkatesh Yedatore, Robert Schwartzman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Pain associated with complex regional pain syndrome (CRPS) is frequently excruciating and intractable. The use of botulinum toxin for relief of CRPS-associated pain has not been well described. Objectives: To assess whether intramuscular botulinum toxin injections cause relief of pain caused by CRPS, and to assess the risks of this treatment. Study Design: Retrospective chart review. Setting: Outpatient clinic. Methods: Patients: 37 patients with spasm/dystonia in the neck and/or upper limb girdle muscles. Intervention: Electromyography-guided injection of botulinum toxin A (BtxA), 10-20 U per muscle. Total dose used was 100 U in each patient. Measurement: Local pain score on an 11 point Likert scale, 4 weeks after BtxA injections. Results: Mean pain score decreased by 43% (8.2 ± 0.8 to 4.5 ± 1.1, P <0.001). Ninety-seven percent of the patients had significant pain relief. One patient had transient neck drop after the injections. Limitations: This is a retrospective study; it lacks a control group and therefore the placebo effect cannot be eliminated. This study does not provide information on the efficacy of this treatment after 4 weeks. Conclusion(s): Intramuscular injection of botulinum toxin A in the upper limb girdle muscles was beneficial for short term relief of pain caused by CRPS in this retrospective case series. The incidence of complications was low (2.7%).

Original languageEnglish (US)
Pages (from-to)311-316
Number of pages6
JournalPain Physician
Volume14
Issue number3
StatePublished - May 2011
Externally publishedYes

Fingerprint

Complex Regional Pain Syndromes
Botulinum Toxins
Pain
Type A Botulinum Toxins
Injections
Upper Extremity
Muscles
Neck
Retrospective Studies
Placebo Effect
Dystonia
Intramuscular Injections
Spasm
Electromyography
Pain Measurement
Ambulatory Care Facilities
Control Groups
Incidence

Keywords

  • Botulinum toxin
  • Complex regional pain syndrome
  • Dystonia
  • Spasm

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Kharkar, S., Ambady, P., Yedatore, V., & Schwartzman, R. (2011). Intramuscular botulinum toxin a (BTXA) in complex regional pain syndrome. Pain Physician, 14(3), 311-316.

Intramuscular botulinum toxin a (BTXA) in complex regional pain syndrome. / Kharkar, Siddharth; Ambady, Prakash; Yedatore, Venkatesh; Schwartzman, Robert.

In: Pain Physician, Vol. 14, No. 3, 05.2011, p. 311-316.

Research output: Contribution to journalArticle

Kharkar, S, Ambady, P, Yedatore, V & Schwartzman, R 2011, 'Intramuscular botulinum toxin a (BTXA) in complex regional pain syndrome', Pain Physician, vol. 14, no. 3, pp. 311-316.
Kharkar S, Ambady P, Yedatore V, Schwartzman R. Intramuscular botulinum toxin a (BTXA) in complex regional pain syndrome. Pain Physician. 2011 May;14(3):311-316.
Kharkar, Siddharth ; Ambady, Prakash ; Yedatore, Venkatesh ; Schwartzman, Robert. / Intramuscular botulinum toxin a (BTXA) in complex regional pain syndrome. In: Pain Physician. 2011 ; Vol. 14, No. 3. pp. 311-316.
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