SCOTTSDALE, AZ – Taiwanese doctors treating diabetic foot pain say that injections of Botulinum toxin type A (A.K.A. Botox)  may help to substantially reduce the foot pain  experienced by diabetic patients. After many years with the disease, people with diabetes can suffer from chronic foot pain due to peripheral nerve damage. Injections performed to the top of the foot, used in a randomized study, demonstrated reduced neuropathic related pain in  study subjects (Source: Reuters Health).

The study was published in the journal, Neurology. A total of 18 patients were studied. The article pointed out that there is recent evidence to suggests that botulinum toxin type A not only inhibits the release of acetylcholine at the neuro-muscular junction, but may also affect afferent sensory nerve fiber firing, relieving neuropathic pain. The participants were randomly assigned to get injections of Botox or saline, then 12 weeks later crossed over to receive the opposite treatment. Because the  study was performed in a double-blind manner, it is useful. However, the small sample number makes it difficult to extrapolate the data on effectiveness in larger populations. This pilot study is encouraging but more research is needed according to the authors.

“intradermal botox injections are an effective and safe method of relieving diabetic neuropathic pain in the feet,”said Dr. Chaur-Jong Hu, at Taipei Medical University, the senior researcher on the study. He cautioned that, “the detailed underlying mechanisms, optimal dosage, and precise course of therapy require further evaluation.”

At the beginning of the study, the average pain score on a scale of 0-10 points was 6.36. At 12 weeks, the score was reduced by 2.53 points with Botox injections compared with 0.53 points with the saline injections. The difference is statistically significant. Up to 44 percent of study subjects experienced a reduction of at least 3 points in their pain score within 12 weeks after the injections. The patients also experienced an improved quality of sleep.

I have not used Botox for this type of medical treatment. If patients are considering such a treatment, they should know that the U.S. Food and Drug Administration has not approved the medication for this usage. Patients would have to consent to this off-label usage for Botulinum A.