There is no evidence that botulinum toxin (Botox) injections reduce chronic neck pain or associated headaches, according to a group of researchers who reviewed nine trials involving 503 participants (Cochrane Database of Systematic Reviews, July 5, 2011).
Some of the trials specifically compared the effects of either giving the toxin, found in antiwrinkle products such as Botox, or a placebo injection of saline to two different groups of people with neck pain. The researchers could see no difference between the two groups at 4 weeks or 6 months. Similarly, adding the toxin to physiotherapy was no more effective than adding either an anesthetic or saline.
"Based on current evidence, we have no reason for supporting the use of botulinum toxin as a standalone therapy for neck pain, but we do suggest that researchers consider further study to clarify whether the dose can be optimized for neck pain," said study spokesperson Paul Michael Peloso, MD, MSc, who works as a director of clinical research at Merck.
Additional trials should be run that look at symptoms other than pain, such as function, to see if there is any reason for believing that this toxin can provide some benefit, the researchers added.
