Botox Versus Medication For Refractory Back Pain: Which Elicits The Most Favourable Outcomes?

Botox Versus Medication For Refractory Back Pain: Which Elicits The Most Favourable Outcomes


There has been much media coverage of the use of Botox to control pain and especially in the area of lower back pain. In fact this has led many patients to ask for Botox as a treatment, especially paravertebral Botox injections. But is Botox the ideal choice for patients and is it any more beneficial than using medication. Well, early results would indicate that Botox is indeed a good solution for refractory back pain and that it may well be a good alternative to surgery or to continued use of facet blocks or lumbar facet blocks and may help patients be less reliant on pain killers in order to control their back pain.


The Case Against Medication


Since lower back pain can often be quite debilitating, painkillers and analgesics have to be strong if they are to control the pain. This means that they often bring about undesirable side effects. Often this can lead to patients feeling drowsy, unable to concentrate effectively or they can have stomach problems etc. Many patients are also very fearful about becoming dependent on these painkillers, particularly if they are derived from opiates.


In addition, the painkillers do not actually cure the back pain, they merely treat the pain which has resulted from something not being right in the spine, discs or nerves. 


So painkillers and analgesics should be seen as a way of controlling pain, but not as a solution to the problem.


Steroid Injections and Lumbar Facet Joint Blocks


Both steroid injections and lumbar facet joint blocks are important weapons in the fight against lower back pain. However, both these treatments may be quite temporary and the patient ends up feeling frustrated and constantly worrying about when the pain may return. Often the effects of both these treatments can wear off within two months of their execution, which means that they provide temporary release, but not long lasting release.


The Case For Botox


Botox is a non invasive procedure that works by the Botox actually paralysing the nerve or area that is causing pain. Like medication it does not stop the cause of the pain, but it effectively numbs it and most patients find that they will be pain free for the next two months or so. Generally therefore there is more pain relief experienced with Botox than with other conservative treatments.


This ‘time off’ from pain can ensure that the root cause of the problem can be sorted out and patients will usually be able to take part in physiotherapy or exercises to help alleviate the cause of their condition. 


No Overall Winner


But whilst there is a strong argument for the use of Botox in treating lower back pain, there is still a role for medication. Botox is generally used when pain has lasted for several months and other forms of treatment have not been successful, but it is not a first course of treatment, since in many cases, medication and painkillers will enable pain levels to be successfully managed, but when these are not successful, Botox is very often an effective solution to refractory back pain.

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