Botulinium Toxin A for Neuropathic Pain

“Botulinum toxin (BoNT) has been used as a treatment for excessive muscle stiffness, spasticity & dystonia for around 40 years, & has recently been used to treat various types of neuropathic pain. The mechanism by which it acts on neuropathic pain involves inhibiting the release of inflammatory mediators & peripheral neurotransmitters from sensory nerves. Recent [medical journals] have demonstrated that BoNT is effective for neuropathic pain, such as postherpetic neuralgia, trigeminal neuralgia & peripheral neuralgia” [1]

Neuropathic pain (NP) is a pain syndrome which is defined by impromptu intermittent or ongoing burning pain, hyperalgesia and allodynia [2]. This intricate chronic pain state, most often accompanied by a tissue injury, can make day to day living very difficult for sufferers who are looking for an alternative to pharmaceuticals, or to cut down on their daily dose. The good news is that scientific research shows that: “Botulinum toxin type A alleviates neuropathic pain and suppresses inflammatory cytokines release from microglia” [2] by targeting specific signalling.

Getting Over the Hurdles

NP is due to nervous system damage which has come about from trauma (e.g. spinal or brain injury), as well as multiple disorders (such as diabetes, stroke, and malignant tumours). According to epidemiological studies: “NP affects approximately 10% of the population, and is usually accompanied with an unsatisfactory treatment outcome. This is partly due to drugs which are not suitable for neuropathic pain. Moreover, research shows that in primary care, the contribution of neuropathy to pain was unrecognized” [2]. To that end, seeing an experienced Pain Specialist who has spent many years in this field, is crucial.

Seeing a Pain Specialist

Once your Pain Specialist has reviewed your medical history, given you an examination, and asked you various questions relating to your pain, he/she will be able to tell you if you are a suitable candidate for Botulinium Toxin. If you are, then you will be given a Personalised Treatment Plan, and will be told about the procedure in laymen’s terms. You will also be invited to ask any questions or discuss any concerns that you may have. The procedure is very quick, and patients find it easy to fit their injections in between their work and family commitments.


[1]. Park J, Park HJ. Botulinum Toxin for the Treatment of Neuropathic Pain. Toxins (Basel). 2017 Aug 24;9(9):260.
[2]. Wang, X., Tian, S., Wang, H. et al. Botulinum toxin type A alleviates neuropathic pain and suppresses inflammatory cytokines release from microglia by targeting TLR2/MyD88 and SNAP23. Cell Biosci 10, 141 (2020).