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12 - Botulinum toxin in the management of back and neck pain

Published online by Cambridge University Press:  02 December 2009

By
Áine Carroll
Edited by
Anthony B. Ward  and
Michael P. Barnes
Áine Carroll
Affiliation:
The National Rehabilitation Hospital, Dun Laoghaire, Co. Dublin, Ireland
Anthony B. Ward
Affiliation:
University Hospital of North Staffordshire
Michael P. Barnes
Affiliation:
Hunters Moor Regional Neurological Rehabilitation Centre
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Summary

Introduction

Musculoskeletal problems are the most common cause of disability in the UK.

Most literature regarding spinal pain concentrates on acute or chronic low back pain rather than neck and thoracic spine pain. Pain from the spinal region, e.g. neck and the low back, is a major health problem in the industrialized world. Although spinal pain is common, its aetiology remains obscure. The association between symptoms, imaging results and anatomical or physiological changes, is weak. Despite often exhaustive investigations, up to 85 per cent of patients with low back pain, will find no definite causal diagnosis. Similar findings apply to neck and shoulder pain.

The most common site of spinal pain is the lower back. Neck pain appears to be almost as frequent, while thoracic pain is less prevalent. Neck symptoms are often poorly differentiated from pain in the shoulder region and the two are therefore often combined. Low back pain and neck pain frequently occur together.

In developed countries, in excess of 70 per cent of the population can expect to experience back pain at some time in their lives. Each year, 15–45 per cent of adults suffer from back pain, and one in 20 people present to a hospital with a new episode. Low back pain presents most commonly between the ages of 35 and 55 years. The vast majority of patients suffer from pain, which is usually moderate or severe and is generally benign.

Type
Chapter
Information
Clinical Uses of Botulinum Toxins , pp. 243 - 261
Publisher: Cambridge University Press
Print publication year: 2007

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