Deadly Poison Helps Low Back Pain

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May 3, 2000 (San Diego) -- What doesn't kill you apparently does make you stronger -- or, at least, keeps your back from hurting. Doctors at a meeting of the American Academy of Neurology here report that by injecting tiny amounts of a deadly poison into the muscles along the spine, they can relax those muscles, thus relieving patients of long-standing low back pain.

This new use for the botulinum toxin could spell relief for the millions of Americans who suffer from constant, daily lower back pain.

Their report on this toxin -- known commonly as Botox -- is the first to look at using a purified form of it to treat patients with chronic low back pain, says Bahman Jabbari, MD, chief of the department of neurology at the Uniformed Services University in Bethesda, Md., and a co-investigator in the research. "This study shows that there is positive result in using Botox in these patients," he says, "and that there may be a role for Botox for certain patients with low back pain."

Even better, the relief lasts about four months, Jabbari says, and the injections can be repeated without loss of effect.

In the study, doctors looked at 28 patients with low back pain that had lasted at least six months in some patients and as long as 30 years in others. After an examination, the patients were given either an inactive salt-water injection or an injection of Botox. Each of the people enrolled in the trial received five shots into the lower back region, next to the spine.

Six of the patients had undergone back surgery five to 15 years before participating in the trial, and four others had experienced a back trauma in the past, but doctors could find no other possible causes for back pain in the other patients.

Lead investigator Leslie Foster, MD, who teaches at the Uniformed Services University, reports that after three weeks of treatment, 11 of 14 patients receiving the Botox injections experienced significant pain relief. The group that got the salt-water injections did not see nearly as much relief.

"This procedure with Botox seems very good," Kevin Rostasy, MD, a research fellow in neurology at Tufts/New England Medical Center in Boston, tells WebMD. "I would hope to see that physical therapy would be added to the treatment of these patients in order to possibly prolong the effects."

No side effects were seen among the patients. "We might have expected some back weakness or difficulty in walking, but we saw the opposite," Jabbari says. "The relief of pain improved their conditions."

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