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DG DISPATCH - AAN: Botulinum may provide low back pain relief By Richard Robinson Special to DG News SAN DIEGO, CA -- May 4, 2000 -- Botulinum toxin injection is effective for some forms of lower back pain, according to a study presented at the 52nd Annual Meeting of the American Academy of Neurology held here May 3, 2000. Botulinum toxin has been used in a variety of conditions marked by muscle overactivity, including dystonia and spasticity. Its muscle-weakening effects last from two to four months in most clinical conditions. To test its efficacy for lower back pain, Bahman Jabbari, MD, and Colleagues at uniformed Services University, in Bethesda, MD, performed a double-blind, placebo-controlled trial in 28 consecutive patients diagnosed with mechanical lower back pain. Patients received either saline or 40 Units Botox into each of five sites in the paravetebral muscles from L1-L5, unilaterally on the side of maximum discomfort. Pain and functional impairment were documented at baseline, and at three and eight weeks, by a Visual Analogue Scale and the Oswestry Low Back Pain Questionnaire (OLBPQ). At three weeks, 11 of 14 treated patients, but only four of 14 placebo patients, showed greater than 50 percent pain relief (p=0.02). At eight weeks, this level of pain relief was achieved by nine of 14 treated patients, but only by two of 14 placebo patients (p=0.01). Functional improvement, as documented on the OLBPQ, 70 percent for treated patients vs. 20 percent for placebo patients. "No side effects were reported by patients," Dr. Jabbari said, "which is significant, since excess weakness might have been expected to lead to gait deterioration. In fact, some treated patients reported a gait improvement." The study was titled, "Botulinum toxin A and mechanical low back pain." Note on units: The difference between unit potency among available brands is a significant issue in BTX treatment. The brand name should always be given when Units are discussed. E-mail this page to a friend or colleague! To print, use this version