Evidence map›Paper›PMID 40711161›Full record

ReviewToxins2025

Intramuscular Botulinum Toxin for Complex Regional Pain Syndrome: A Narrative Review of Published Cases.

Marc Klee, Nilkolaj la Cour Karottki, Bo Biering-Sørensen

Abstract readReview
In one paragraph

Review in Toxins, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Marc KleeMovement Disorder and Pain Research Center, Rigshospitalet Glostrup, 2600 Glostrup, Denmark.ORCID 0009-0007-5728-9385
Nilkolaj la Cour KarottkiMovement Disorder and Pain Research Center, Rigshospitalet Glostrup, 2600 Glostrup, Denmark.ORCID 0000-0003-1207-1845
Bo Biering-SørensenMovement Disorder and Pain Research Center, Rigshospitalet Glostrup, 2600 Glostrup, Denmark.ORCID 0000-0002-7682-1353

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince the 1980s, numerous case reports have explored the use of intramuscular botulinum toxin (BoNT) for Complex Regional Pain Syndrome (CRPS), with significant variation in rationale, dosing, guidance techniques, and outcome measures. This narrative review aims to summarize published evidence on the use of intramuscular BoNT in patients with CRPS, including studies using earlier terminology such as reflex sympathetic dystrophy (RSD). Given the heterogeneous and largely anecdotal nature of the literature, this review is intended to map the existing landscape rather than conduct a formal analysis.

methodsThe PubMed and EMBASE databases were searched in August 2024 using terms related to CRPS and botulinum toxin. Following abstract and full-text screening, 25 publications were included.

resultsThe included studies span single case reports, case series, and small cohorts, encompassing at least 96 individual CRPS patients treated with intramuscular BoNT. Reported outcomes were heterogeneous, and key treatment parameters-such as toxin type, target muscles, guidance technique, and dosing-were inconsistently reported.

conclusionThe evidence for intramuscular BoNT in CRPS remains limited and heterogeneous, preventing firm conclusions on its efficacy or safety. Its use may be considered in select cases, particularly those with disabling or painful focal dystonia or myofascial pain, but standardized prospective studies are needed to clarify its clinical role.

Indexed as

Botulinum ToxinsComplex Regional Pain SyndromesNeuromuscular AgentsHumansInjections, IntramuscularTreatment OutcomeBotulinum ToxinsNeuromuscular Agentsbotulinum toxinComplex Regional Pain Syndromenarrative review

Identifiers

PMID40711161
PMCPMC12298518

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.