Botulinum toxin for the treatment of chronic pain. Review of the evidence

Abstract

IntroductionChronic pain is one of the primary reasons why people seek medical help. It produces functional limitation, affects mood, and impairs job performance. Many times it is difficult to manage and responds poorly to pharmacological therapies, posing a challenge for the multidisciplinary team in charge of treating this disorder. A number of approaches to relieve pain are the subject of growing research, including the application of agents such as botulinum toxin on painful points. ObjectiveTo carry out a non-systematic narrative review of the scientific evidence available on the use of botulinum toxin for the treatment of chronic pain. Materials and methodsA search was conducted in the PUBMED database, including meta-analyses, systematic reviews, Cochrane reviews, clinical trials, narrative reviews and case series, published between 1997 and 2013, in order to carry out a non-systematic narrative review. ResultsOverall, 66 articles were considered for an update on the proposed topic. ConclusionsBotulinum toxin has certain properties that might have a beneficial effect on chronic pain. However, there is not sufficient evidence supporting its use in the majority of indications in this group of patients. Additional studies are required to recommend its use. Ultrasound is considered a useful tool to guide its application.