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document
Treatment of whiplash associated neck pain [ corrected ] with botulinum toxin-A : a pilot study . OBJECTIVE Up to 87 % of patients with whiplash associated disorder ( WAD ) have some degree of muscle spasm that is contributory to both pain and dysfunction . Botulinum toxin A ( BTX-A ) produces prolonged muscle relaxation that is dose-dependent and can be easily targeted to affected muscles . BTX-A therapy may be an effective form of therapy offering an alternative or adjunct to conventional modalities . We investigated BTX-A as therapy in patients with WAD . METHODS This randomized , double blind , placebo controlled study compares outcome measures in 26 patients with chronic neck pain ( WAD-II chronic ) subsequent to a motor vehicle accident . One-half of the patients received 100 units BTX-A , diluted in 1 ml saline , while the other half received just saline ( 1 ml ) . Five trigger points received 0.2 ml each of injectant via a 30 gauge needle . Outcome measures included total subjective neck , shoulder , and head pain based on visual analog scales ; objective total range of neck motion ( ROM ) , and the Vernon-Mior subjective function index . Followup assessments were carried out at 2 and 4 weeks post-treatment . RESULTS Fourteen subjects receiving BTX-A and 12 receiving saline completed the study . The treatment group showed a trend toward improvement in ROM and reduction in pain at 2 weeks post-injection . At 4 weeks post-injection the treatment group was significantly improved from preinjection levels ( p < 0.01 ) . The placebo group showed no statistically significant changes at any post-treatment time . The Vernon-Mior scale revealed a trend to improvement for both groups . CONCLUSION BTX-A treatment of subjects with chronic WAD II neck pain resulted in a significant ( p < 0.01 ) improvement in ROM and subjective pain compared to a placebo group , but only a trend to improvement in subjective functioning .
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Intervention_Pharmacological
botulinum toxin-A :
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Intervention_Pharmacological
Botulinum toxin A ( BTX-A )
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Intervention_Pharmacological
BTX-A
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Intervention_Control
placebo
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Intervention_Pharmacological
100 units BTX-A , diluted in 1 ml saline
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Intervention_Control
other half received just saline
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Intervention_Pharmacological
BTX-A
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Intervention_Pharmacological
BTX-A
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Outcome_Pain
total subjective neck , shoulder , and head pain based on visual analog scales
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Outcome_Physical
objective total range of neck motion ( ROM ) ,
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Outcome_Physical
Vernon-Mior subjective function index
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Outcome_Physical
ROM
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Outcome_Pain
pain
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Outcome_Physical
Vernon-Mior scale
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Outcome_Physical
ROM
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Outcome_Pain
subjective pain
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Outcome_Physical
subjective functioning
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Participant_Condition
WAD
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Participant_Sample-size
26
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Participant_Condition
chronic neck pain
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Participant_Sample-size
Fourteen