Botox May Aid in Chronic Neck, Back Pain
Wed Feb 25,10:29 AM ET Add Health - Reuters to My Yahoo!

By Amy Norton

NEW YORK (Reuters Health) - Botox injections may help ease stubborn pain in the neck and upper back when other treatments fail, preliminary research shows.

The study of 25 patients whose chronic pain had resisted other therapies found that a single round of Botox injections coupled with physical therapy brought pain relief within a month.

Though widely known as a banisher of frown lines, botulinum toxin type A -- sold as Botox -- has long been used to treat uncontrolled muscle contractions that mark a number of medical conditions, such as cerebral palsy and chronic eye-muscle spasms.

Botox is a purified form of the toxin that causes botulism food poisoning. When injected in small doses, botulinum toxin helps relax spastic muscles by preventing nerve cells from releasing a chemical that triggers muscle contractions.

Dr. Amy M. Lang, the author of the new study, said lab research suggests Botox may also block certain pain-promoting proteins in the body. Besides relaxing and lengthening chronically contracted muscle, it may "dampen" pain signals sent to the central nervous system, she explained in an interview.

Lang, a physical medicine and rehabilitation specialist in private practice in Lawrenceville, Georgia, has used Botox in pain management for the past 10 years. She said she turns to it only after establishing that the problem is in the muscle, addressing contributing factors like poor body alignment and mechanics, and trying more-traditional therapies like exercise, pain medication and massage therapy.

Her study, published in the American Journal of Pain Management, included 25 patients with pain in the neck and upper back area that had persisted at least three months despite treatment. All received one round of Botox injections into their problem muscles, along with physical therapy.

Patients rated their pain on a 10-point scale at the start of the study, then several times during the three months following treatment. Lang found that patients' pain scores began to decline within four weeks of treatment, and at week eight had dropped nearly 40 percent, on average.

When it comes to muscular pain, Lang said, the benefits of Botox can last six months or even longer. Its ability to relax and lengthen muscle may make it easier for patients to improve with physical therapy. Lang noted that in her experience, many patients treated with Botox have been able to stop taking pain medication.

In this study, three patients had treatment-related side effects, including numbness in the neck and arm, soreness at the injection site, and probable migraine. Fifty-seven percent said they would "definitely" get Botox injections again for their pain, while 10 percent said they would not.