Intramuscular botulinum toxin in complex regional pain syndrome: Case series and literature review

Siddharth Kharkar, Prakash Ambady, Yedatore Venkatesh, Robert J. Schwartzman

Research output: Contribution to journalArticle

22 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: Thirty-seven patients with spasm/dystonia in the neck and/or upper limb girdle muscles. Intervention: EMG-guided injection of Botulinum toxin-A (BtxA), 10-20 units per muscle. Total dose used was 100 units in each patient. Local pain score was measured 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). 97% of 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 so the placebo effect cannot be eliminated. This study does not provide information on the efficacy of this treatment after 4 weeks. Conclusions: Intramuscular injection of botulinum toxin in the upper limb girdle muscles was beneficial for short term relief of pain caused by CRPS. The incidence of complications was low (2.7%) Institutional Review: This study was approved by the Institutional Review Board of the Drexel College of Medicine.

Original languageEnglish (US)
Pages (from-to)419-424
Number of pages6
JournalPain Physician
Volume14
Issue number5
StatePublished - Sep 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
Research Ethics Committees
Intramuscular Injections
Spasm
Ambulatory Care Facilities
Medicine
Control Groups
Incidence

Keywords

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

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Intramuscular botulinum toxin in complex regional pain syndrome : Case series and literature review. / Kharkar, Siddharth; Ambady, Prakash; Venkatesh, Yedatore; Schwartzman, Robert J.

In: Pain Physician, Vol. 14, No. 5, 09.2011, p. 419-424.

Research output: Contribution to journalArticle

Kharkar, S, Ambady, P, Venkatesh, Y & Schwartzman, RJ 2011, 'Intramuscular botulinum toxin in complex regional pain syndrome: Case series and literature review', Pain Physician, vol. 14, no. 5, pp. 419-424.
Kharkar, Siddharth ; Ambady, Prakash ; Venkatesh, Yedatore ; Schwartzman, Robert J. / Intramuscular botulinum toxin in complex regional pain syndrome : Case series and literature review. In: Pain Physician. 2011 ; Vol. 14, No. 5. pp. 419-424.
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