Botulinum (Botox) injection for low back pain

Botulinum toxin A is a protein produced by the bacteria Clostridium botulinum, the same bacteria that causes botulism food poisoning. When injected into muscle in tiny amounts, botulinum A (Botox) can stop or reduce muscle spasm by blocking nerve signals to the muscle. This treatment has been used since the early 1990s to relieve severe muscle spasms around the eyes and in the neck, arms, legs, hands, and feet. Some people with cerebral palsy have gained significant relief from severe muscle contraction with botulinum toxin injections.

Botulinum toxin A has recently been tried as a treatment for chronic low back pain. Although this practice is experimental and not well-tested, it has shown early promise. In one small study of 31 people with chronic low back pain, botulinum A injection was compared to saline injection into painful back muscles.¹

• 3 weeks after treatment, about 73% of botulinum toxin recipients reported pain relief of 50% or more, while only 25% of the saline group did.
• 8 weeks after treatment, 60% of botulinum recipients reported pain relief of 50% or more, while only 12% of the saline group did.
• Pain relief was reported by most people as lasting 3 to 4 months.

The small size of the study makes it impossible to guarantee that botulinum toxin injection is an effective and safe treatment for you.

Talk to your doctor about the risks and benefits of this medicine and its unlabeled use. Severe side effects have been reported.

Citations

1. Foster L, et al. (2001). Botulinum toxin A and chronic low back pain: A randomized, double-blind study. Neurology, 56(10): 1290–1293.