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, Buzzatti, Luca, Gandolfi, Marialuisa, Finocchi, Cinzia, Falsiroli Maistrello, Luca, Viceconti, Antonello, 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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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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