Dr KK Aggarwal
(NIH): According to results
published in Regional Anesthesia & Pain Medicine, treating pelvic
floor muscle spasm with botulinum toxin may relieve pain and improve quality of
life. The study was conducted by scientists at the National Institute of
Neurological Disorders and Stroke (NINDS), part of the National Institutes of
Health.
In the study, women with
surgically treated endometriosis who were generally taking hormones to suppress
menses, but who continued to experience pain and had pelvic floor muscle spasm,
initially received injections of botulinum toxin or saline as part of
a placebo-controlled clinical trial, targeting areas of spasm. At least one
month after the masked study injection, 13 participants chose to receive
open-label botulinum toxin injections in areas that remained in spasm and were
then followed for at least four months. These patients were described in the
current study at the NIH Clinical Center.
· In
all participants, during follow-up, pelvic floor muscle spasm was not
detected or occurred in fewer muscles.
· Within
two months of receiving the injections, pain decreased in all of the
participants, with 11 out of 13 subjects reporting that their pain was mild
or had disappeared.
· Additionally,
usage of pain medication, including opioids, was reduced in more than
half of the participants.
· Prior
to receiving toxin injections, eight participants reported moderate or severe
disability and after treatment, six of those patients noted an improvement
in disability.
These findings suggest that
pelvic floor muscle spasm may be experienced by women with endometriosis and
contribute to pain persisting after standard treatment. Importantly, the
beneficial effects were long-lasting, with many patients reporting pain
relief lasting at least six months.
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of
Medical Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of
India
Past National President
IMA
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