Botulinum toxin injection for back pain

Spire Clare Park Hospital in Farnham, Surrey, has a dedicated multi-disciplinary team, including, physiotherapists, pain management consultants and orthopaedic spinal surgeons available to diagnose and treat a range of back pain problems.

Ask your GP for a referral to Spire Clare Park Hospital or alternatively, contact our Patient Information Advisers on 01252 895 or complete the form on the right-hand side of this page. 

About botulinum toxin injections

Botulinum toxin, derives from the bacteria Clostridium Botulinum. 

Botulinum toxin is thought to act by two distinct mechanisms. It has a direct pain killing effect (anti-nociceptive effect) as a result of blocking central transmission of pain impulses from the periphery to the brain. It also acts on muscle nerves resetting the level of contraction and thereby reducing muscle spasm.

Whilst the number of clinical indications for botulinum toxin has escalated dramatically over the last 5 years it is not a new drug or novel technique. It has been used cosmetically for around 15 years and indeed some of its beneficial effects in terms of pain alleviation were discovered from its use cosmetically. An example of this is the use of botulinum toxin in migraine prophylaxis where early indications of its potential benefit were derived from patients undergoing cosmetic treatment with Botox and noting a decrease in the frequency and severity of their migraine headaches.

The incidence of side effects or complications with botulinum toxin is incredibly small. Unlike other analgesic preparations it does not cause systemic upset, central effects such as light headedness or failure of concentration, liver or kidney toxicity. There are no reported cases of allergy and improvements in manufacturing processes have resulted in an increase in the purity of the product and hence a decrease in tolerance secondary to the formation of antibodies on repeated injections.

Other complications are exclusively related to dosage and as such it is essential that botulinum toxin injections are performed by an individual experienced and competent in the delivery of botulinum toxin injections.

The onset of action of botulinum toxin is approximately 2 weeks after injection.

Currently in the UK botulinum toxin has a product licence for the treatment of cervical dystonia and various ophthalmic conditions such as strabismus or blepharospasm. It may be given however in a number of different conditions and studies are now emerging indicating its effectiveness in the treatment of:

  • painful neck pain associated with muscle spasm
  • piriformis syndrome
  • complex regional pain syndrome
  • lower back pain associated with muscle spasm
  • migraine

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