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No Benefits of Botulinum Toxin Found for Chronic Neck Pain

No evidence of botulinum improving chronic neck pain with or without cervicogenic headache

MONDAY, July 11 (HealthDay News) -- There is no evidence confirming either clinically important or statistically significant benefits of botulinum toxin type-A (BoNT-A) for chronic neck pain, with or without cervicogenic headache, according to a review published in the July issue of the Cochrane Database of Systematic Reviews.

Pierre Langevin, from Université Laval in Quebec City, and colleagues reviewed available literature through September 2010 to evaluate the effectiveness of BoNT-A treatment for neck pain, disability, global perceived effect, and quality of life in adults with neck pain with or without associated cervicogenic headache. Adults with cervical radiculopathy and whiplash-associated disorder were excluded from the analysis. A total of nine randomized and quasi-randomized controlled trials with 503 participants using BoNT-A were included in the analysis.

The researchers found high-quality evidence of little or no difference in chronic neck pain between BoNT-A and saline injections at four weeks and six months. Combining BoNT-A and saline with exercise and analgesics showed little or no pain difference at four weeks and six months based on low-quality evidence. One trial on patients with chronic cervicogenic headache showed little or no difference between BoNT-A and placebo at four weeks and six months based on very low-quality evidence. Another trial on chronic neck pain showed a difference in global perceived effect in favor of BoNT-A at four weeks based on very low quality evidence.

"Current evidence fails to confirm either a clinically important or a statistically significant benefit of BoNT-A injection for chronic neck pain associated with or without associated cervicogenic headache," the authors write.

One of the authors disclosed a financial relationship with Merck, and the review was funded by LifeMark Health.

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