Botox injections could help pain relief for Ukrainian war amputees
Botox is widely known to smooth out wrinkles, but it may also help relieve phantom limb pain in Ukrainian war amputees, researchers found.
More than 100,000 soldiers and civilians are estimated to have lost limbs since Russia’s full-scale invasion in 2022.
Most amputees experience some degree of stump pain or “phantom limb” pain; here the patient can still feel actual pain in the amputated limb.
But a study conducted by Northwestern Medicine and Ukrainian doctors, which included 160 amputees treated at two hospitals in Western Ukraine between 2022 and 2024, found that this pain can be significantly reduced using Botox.
Co-author Dr. D., an anesthesiologist and intensivist at the Multidisciplinary Emergency and Intensive Care Clinical Hospital in Lviv, Ukraine. “Our results suggest that botulinum toxin may be a potentially powerful short-term tool to treat post-amputation pain when used alongside comprehensive medical and surgical care,” said Roman Smolynets.
“This could be another step towards helping amputees live with less pain and more dignity. But not as monotherapy, but always as an adjunct to comprehensive medical and surgical care.”
Botox, the brand name for the injectable drug botulinum toxin, is known for its use in cosmetic procedures to freeze muscles by blocking the nerve signals that cause muscles to contract.
However, it is also used to reduce chronic pain, migraine and muscle disorders.
In the study, researchers used a new method to inject botulinum toxin directly around painful nerve endings and surrounding soft tissues, rather than into muscle or skin.
Scientists said this helps reduce nerve activity and local inflammation. Researchers have suggested that it may also help relieve other nerve pain, such as pain due to shingles, carpal tunnel syndrome, and pain after surgeries such as mastectomies.
Participants in the study were amputees receiving treatment at the Lviv First Medical Corps or the Ivano-Frankivsk Regional Hospital.
One group of participants received botulinum toxin injections around painful nerve endings, called neuromas, in addition to standard medical and physical therapy.
The other group received medical and surgical treatment, including nerve blocks, physical and psychological therapy, and medication.
Pain levels were assessed on a 10-point scale at the beginning of treatment and three months later, taking into account phantom limb pain and pain in the stump.
The results showed that after one month, the botulinum toxin group experienced an average four-point reduction in phantom limb pain on a 10-point scale; In comparison group patients, it was only one point.
After one month, 69 percent of patients receiving botulinum toxin noticed improvement in phantom limb pain, compared with only 43 percent in the other group receiving conventional treatments.
But these benefits only last three months; This is consistent with previous research showing that the pain-relieving effects of botulinum toxin generally last for about three months.
senior study author Dr. D., assistant professor of anesthesiology at Northwestern University Feinberg School of Medicine. “As a retired colonel and the father of an infantryman who suffered a traumatic brain injury while at the U.S. Military Academy and may be deployed in future conflicts, this research has special personal meaning to me,” said Steven Cohen.
Dr Cohen and colleagues stressed that larger studies are needed to confirm their findings, and they aim to investigate whether repeated botulinum toxin injections over time can provide lasting benefits for post-amputation pain.
