Botox injections may ease diabetic foot pain

People with diabetes often suffer from chronic foot pain because of nerve damage, but relief may be at hand. Taiwanese doctors have shown that the pain can be reduced substantially by injections of botulinum toxin type A - better known as Botox - into the skin on top of the foot.

Dr. Chaur-Jong Hu, at Taipei Medical University, and associates tested the treatment in 18 patients with type 2 diabetes who had nerve-related pain in both feet.

The participants were randomly assigned to get injections of Botox or saline, then 12 weeks later crossed over to receive the opposite treatment.

A local anesthetic gel was applied first, and then the injections were administered into the skin (rather than into muscles) at 12 sites across the top of the foot, the team explains in the medical journal Neurology.

At the start of the study, the average pain score on a scale of 0-10 points was 6.36. There were significant differences in the decrease in pain scores between the Botox and saline injections during each 12-week period.

Specifically, at 12 weeks, the score was reduced by 2.53 points with Botox injections compared with 0.53 points with the saline injections.

Moreover, 44 percent of the subjects had a reduction of at least 3 points in their pain score within 12 weeks after the Botox injections.

An added benefit was that patients are able to sleep much better after the treatment.

Hu's team concludes that intradermal Botox injections "are an effective and safe method of relieving diabetic neuropathic pain in the feet." However, "the detailed underlying mechanisms, optimal dosage, and precise course of therapy require further evaluation."

SOURCE: Neurology, April 28, 2009.