This story explores what is known about the application of botulinum toxin injection for relief of pain. It included anecdotes from two individuals with different types of pain who obtained pain relief following injection with Botox. However the story did not include enough information for readers about the risks and benefits of this experimental approach.
The story does, to its credit, explain that this treatment is worthy of further study and not yet ready for widespread use. However, the story may have painted an overly optimistic picture of Botox as a possible answer for chronic pain, given the very limited trial experience.
Although rare, there are several potentially serious reactions that can result from injection of Botox, and the story never mentioned these. Especially relevant to the chronic pain application discussed in this story, some treatment benefits are relatively short lived and some people experience diminished response over time.
Costs weren't mentioned, and this new idea wasn't compared with any standard of care for pain relief.
There is no mention of the costs of Botox injections.
There was no quantification of the benefits of botox injection for pain relief. One person reported that botox injection resulted in the best six years in terms of pain; another reported that botox injection provided relief from migraine headache. However these anecdotes do not provide the reader with a real sense of the magnitude of relief that this experimental approach typically yields.
There was no mention of potential harms of the treatment. The story quoted the researcher saying "It seems to be a relatively safe treatment option, [but] to be fair, we don't have long-term data." However, it failed to mention that there may be undesired local effects along the nerve(s) at the injection site or that patients can develop allergic reations that may be life threatening following repeated injection of this material.
The story mentioned that there was 'some evidence' that Boxtox may interfere with nerve signals associated with pain. However, it failed to explain the nature of this evidence – whether it was from animal experiments, controlled trials with people or even the nature of the pain in which the effect was observed.
The study described in this story is a phase I clinical trial that is still in the recruitment phase and thus the results are far too preliminary to allow conclusions.
This story does not engage in disease mongering.
The story is based largely on one Mayo Clinic physician and her patients. But there was input from an Arthritis Foundation source.
This story did not mention any other options for pain relief, nor did it compare the Botox injections with any standard of care.
This story doesn't explain if botox injections are approved by the FDA for use in treating pain. Although Botox has FDA approval for other applications, using it to treat this sort of pain would represent what is termed an 'off-label' use. The story doesn't describe such off-label uses or the ramifications thereof.
It's clear from the story that Botox has been used for years for other uses. The experiments in pain therapy were termed a "novel idea."
Although the story is based largely on one Mayo Clinic physician and her patients, there was input from an Arthritis Foundation source. So the story did not appear to rely solely or largely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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