O Uso da Toxina Botulínica no Controlo da Dor na Lombalgia

Abstract

Introduction : Low back pain is the most prevalent musculoskeletal disorder, affecting 40%-80% of individuals worldwide, representing a major disability factor in quality of life and enormous costs for the society. The present review aims to reflect on scientific evidence that evaluates the role of botulinum toxin (BT) as a treatment of low back pain. Methods : The present study is a systematic review. The authors reviewed the literature indexed in the databases Medline (via PubMed), Web of Science and CENTRAL. To achieve study purposes, only randomized clinical trials (RCT) were included, with at least 2 months of follow-up, appropriate sample size and in line with the standards of the Delphi List. Results : In the evidence contemplated, BT therapy proved to be superior in pain control and in the improvement of functional capacity when compared with placebo. On the other hand, the treatment of BT + physiotherapy showed more effectiveness versus 1) placebo + physiotherapy and versus 2) therapy of infiltrations with corticosteroid and local anesthetic (triamcinolone and lidocaine) + physiotherapy, regarding pain control of low back pain. Conclusion : Even though the approached studies indicate the important role of BT in low back pain management, the consolidation of these conclusions need scientific evidence with higher quality, larger randomized clinical trials, standardization of the evaluated outcomes and detailed intervention protocols. BT therapy, integrated in a multimodal approach, may be a relevant asset in the management of low back pain.