Abstract
BackgroundDespite 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.MethodsWe searched and critically reviewed evidence for the efficacy of BoNT for the treatment of chronic pain.ResultsMeta-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.ConclusionsBoNT 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.
Highlights
The prevalence of moderate-to-severe chronic non-cancer pain in Europe is estimated to be 20% [1]
A meta-analysis on the role of Botulinum neurotoxin (BoNT) as a prophylactic treatment of migraine showed that BoNT type A (BoNT-A) compared with placebo was associated with a small-to-modest benefit for chronic daily headache and chronic migraine (CM), but was not associated with fewer episodic migraine or chronic tension-type headaches (TTHs) per month [18]
A Randomized controlled trial (RCT) on the treatment of Medicationoveruse headache (MOH) failed to document an effect on the headache days, but showed a reduction of drug consumption [19]
Summary
The prevalence of moderate-to-severe chronic non-cancer pain in Europe is estimated to be 20% [1]. A large population-based study on the prevalence of primary headache (PH) disorders in Germany estimated that 2.6% of the general population suffer from headache ≥15 days/ month, and 1.1% from chronic migraine [2]. Medicationoveruse headache (MOH), i.e., chronic headache resulting from excessive consumption of pain-killers for headache, has an estimated worldwide prevalence of 0.5–7.2% [3]. Despite their huge epidemiological impact, primary headaches, trigeminal neuralgia and other chronic pain conditions still receive suboptimal medical approach, even in developed countries. Botulinum neurotoxin (BoNT) represents a well-established and licensed treatment for chronic migraine, and an emerging treatment for other types of primary headache, trigeminal neuralgia, neuropathic pain, and an increasing number of 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
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
