Efficacy of botulinum toxin type a in the relief of Carpal tunnel syndrome: A preliminary experience.

Abstract

BACKGROUND AND OBJECTIVES:

Botulinum toxin type A has been shown to relieve primary headaches, myofascial pain and various neuropathic pains. Carpal tunnel syndrome (CTS) is a common disorder resulting from median nerve compression at the wrist. As reports of botulinum toxin A in the treatment of CTS were limited, this study set out to evaluate the safety and tolerability of botulinum toxin A and its effects on the relief of nerve entrapment and pain in patients with CTS.

METHODS:

We conducted an open-label, prospective pilot study using 60 units of botulinum toxin A injected intracarpally in patients with primary CTS. Changes in median nerve conduction velocities, distal latencies, compound muscle action potentials and visual analogue scale (VAS) pain scores were evaluated for 3 months following injection. All adverse experiences, reported spontaneously or observed directly by the investigator, were recorded.

RESULTS:

Five women aged 52.2 +/- 2.5 years with 1-2 years' history of CTS were enrolled. Botulinum toxin A was well tolerated and safe. No exacerbated hand weakness was observed in any of the patients. At 3 months, pain was lessened in three patients, remained static in one patient, and was aggravated in one patient. The VAS pain score showed a trend to improvement during the 3 months of follow-up, although it did not reach statistical significance (p = 0.2).

CONCLUSION:

Our data suggest long-lasting antinociceptive effects of botulinum toxin A rather than electrophysiological restoration in patients with CTS. Intracarpal injection of botulinum toxin A was shown to be well tolerated and safe. A double-blind, placebo-controlled trial of botulinum toxin A in CTS is warranted since the current study may have been confounded by the placebo effect of intracarpal injection.

• Authors: Ching-Piao Tsai, Chih-Yang Liu, Kon-Ping Lin, Kai-Chen Wang
• Journal: Clinical drug investigation (Clin Drug Investig) Vol. 26 Issue 9 Pg. 511-5 ( 2006) ISSN: 1173-2563 [Print] New Zealand
• PMID: 17163284 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Botulinum Toxins, Type A

Topics

• Botulinum Toxins, Type A (therapeutic use)
• Carpal Tunnel Syndrome (drug therapy)
• Female
• Humans
• Middle Aged
• Prospective Studies