Efficacy of botulinum toxin type a for treating chronic low back pain: a systematic review and metanalysis.

Study Summary

5 randomized controlled trials including 177 patients with nonspecific chronic low back pain were included in this systematic review and meta-analysis comparing botulinum toxin type A (BoNT-A) vs placebo or saline injections. Pooled outcomes of interest included clinically significant pain response, functional improvement, treatment durability, and dose-response effects. BoNT-A significantly improved the proportion of patients achieving at least 50% pain reduction and significantly improved functional response compared with placebo, although exploratory analysis suggested that pain benefits may decline with longer follow-up. Overall, these findings suggest that BoNT-A may provide short-term pain and functional benefit in nonspecific chronic low back pain, but confidence in the evidence remains limited.