A focused review on the use of botulinum toxins for neuropathic pain

Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S177-81. doi: 10.1097/00002508-200211001-00010.


Understanding the pathophysiology of a pain syndrome is helpful in selecting appropriate treatment strategies. Nociceptive pain is related to damage to tissues due to thermal, chemical, mechanical, or other types of irritants. Neuropathic pain results from injury to the peripheral or central nervous system. Common examples of neuropathic pain include postherpetic neuralgia, diabetic neuropathy, complex regional pain syndrome, and pain associated with spinal cord injuries. Nociceptive pain may have similar clinical characteristics to neuropathic pain. It is also possible for acute nociceptive pain to become neuropathic in nature, as with myofascial pain syndrome. A clear benefit of botulinum toxin therapy for treatment of neuropathic pain disorders is that it often relieves pain symptoms. Although the precise mechanism of pain relief is not completely understood, the injection of botulinum toxin may reduce various substances that sensitize nociceptors. As a result, botulinum toxin types A and B are now being actively studied in nociceptive and neuropathic pain disorders to better define their roles as analgesics.

Publication types

  • Review

MeSH terms

  • Botulinum Toxins / therapeutic use*
  • Botulinum Toxins, Type A / therapeutic use*
  • Brachial Plexus Neuropathies / complications
  • Brachial Plexus Neuropathies / drug therapy
  • Clinical Trials as Topic
  • Herpes Zoster / complications
  • Herpes Zoster / drug therapy
  • Humans
  • Myofascial Pain Syndromes / drug therapy
  • Myofascial Pain Syndromes / etiology
  • Nervous System Diseases / complications*
  • Nervous System Diseases / drug therapy*
  • Neuralgia / drug therapy
  • Neuralgia / etiology
  • Pain / drug therapy*
  • Pain / etiology*
  • Polyneuropathies
  • Reflex Sympathetic Dystrophy / drug therapy
  • Reflex Sympathetic Dystrophy / etiology
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / drug therapy
  • Treatment Outcome


  • rimabotulinumtoxinB
  • Botulinum Toxins
  • Botulinum Toxins, Type A