Botulinum toxin A and chronic low back pain - A randomized, double-blind study

Objectives: To investigate the efficacy of botulinum toxin A in chronic low back pain and associated disabilities. Methods: Thirty-one consecutive pat ients with chronic low back pain who met the inclusion criteria were studie d: 15 received 200 units of botulinum toxin type A, 40 units/site at five l umbar paravertebral levels on the side of maximum discomfort, and 16 receiv ed normal saline. Each patient's baseline level of pain and degree of disab ility was documented using the visual analogue scale (VAS) and the Oswestry Low Back Pain Questionnaire (OLBPQ). The authors reevaluated the patients at 3 and 8 weeks (visual analogue scale) and at 8 weeks (OLBPQ). Results: A t 3 weeks, 11 of 15 patients who received botulinum toxin (73.3%) had >50% pain relief vs four of 16 (25%) in the saline group (p = 0.012). At 8 weeks , nine of 15 (60%) in the botulinum toxin group and two of 16 (12.5%) in th e saline group had relief (p = 0.009). Repeat OLBPQ at 8 weeks showed impro vement in 10 of 15 (66.7%) in the botulinum toxin group vs three of 16 (18. 8%) in the saline group (p = 0.011). No patient experienced side effects. C onclusion: Paravertebral administration of botulinum toxin A in patients wi th chronic low back pain relieved pain and improved function at 3 and 8 wee ks after treatment.