The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis

Battista, Simone and Buzzatti, Luca and Gandolfi, Marialuisa and Finocchi, Cinzia and Falsiroli Maistrello, Luca and Viceconti, Antonello and Giardulli, Benedetto and Testa, Marco (2021) The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis. Toxins, 13 (9). p. 640. ISSN 2072-6651

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Official URL: https://doi.org/10.3390/toxins13090640

Abstract

Several studies have investigated the effect of botulinum toxin A (BoNT-A) for managing chronic musculoskeletal pain, bringing contrasting results to the forefront. Thus far, however, there has been no synthesis of evidence on the effect of BoNT-A as an adjunctive treatment within a multimodal approach. Hence, Medline via PubMed, EMBASE, and the Cochrane Library-CENTRAL were searched until November 2020 for randomised controlled trials (RCTs) that investigated the use of BoNT-A as an adjunctive therapy for chronic musculoskeletal pain. The risk of bias (RoB) and the overall quality of the studies were assessed through RoB 2.0 and the GRADE approach, respectively. Meta-analysis was conducted to analyse the pooled results of the six included RCTs. Four were at a low RoB, while two were at a high RoB. The meta-analysis showed that BoNT-A as an adjunctive therapy did not significantly decrease pain compared to the sole use of traditional treatment (SDM −0.89; 95% CI −1.91; 0.12; p = 0.08). Caution should be used when interpreting such results, since the studies displayed very high heterogeneity (I = 94%, p < 0.001). The overall certainty of the evidence was very low. The data retrieved from this systematic review do not support the use of BoNT-A as an adjunctive therapy in treating chronic musculoskeletal pain.

Item Type: Journal Article
Keywords: botulinum toxins, type A, botulinum toxins, rehabilitation, physical and rehabilitation medicine, musculoskeletal pain, musculoskeletal disease, chronic pain, physical therapy modalities, physical therapy specialty, combined modality therapy
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 28 Sep 2021 13:49
Last Modified: 17 Jan 2022 15:23
URI: https://arro.anglia.ac.uk/id/eprint/706979

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