Methods for therapeutic treatment of carpal tunnel syndrome

Abstract

A method of treating and/or preventing carpal tunnel syndrome (CTS) is provided, comprising administering a therapeutically effective amount of a botulinum toxin to a patient in need thereof or a patient at risk for development of CTS. More specifically, the method includes one or more injections of a botulinum toxin over a period of time into one or more muscles of the hand and/or wrist, or directly into the carpal tunnel along the median nerve. Pharmaceutical compositions are provided as are combination therapies with other agents such as anti-inflammatory drugs, growth factors, and agents useful in the treatment of neuropathic pain. The use of the methods of the present invention are also contemplated with other treatment regimens used to treat patients having carpal tunnel syndrome.

1 . A method of treating carpal tunnel syndrome (CTS), comprising administering a therapeutically effective amount of a botulinum toxin to a subject in need thereof. 
     
     
         2 . The method of  claim 1 , wherein the botulinum toxin is administered as one or more injections into the muscles of the palm, wrist, and/or hand. 
     
     
         3 . The method of  claim 1 , wherein the botulinum toxin is administered as one or more injections directly into the carpal tunnel along the median nerve. 
     
     
         4 . The method of  claim 1 , wherein the botulinum toxin is conjugated to a growth factor having specific receptors on the median nerve. 
     
     
         5 . The method of  claim 4 , wherein the growth factor is selected from the group consisting of IGF-I, IGF-III and glial derived neurotrophic factor. 
     
     
         6 . The method of  claim 2 , wherein the botulinum toxin is administered in two or more equal injections. 
     
     
         7 . The method of  claim 6 , wherein the botulinum toxin is administered in three equal injections. 
     
     
         8 . The method of  claim 2 , wherein the muscles treated are one or more muscles selected from the group consisting of the palmaris brevis muscle, the opponens digiti minimi muscle, and flexor digiti minimi muscle. 
     
     
         9 . The method of  claim 1 , wherein the therapeutically effective amount of botulinum toxin is effective to result in diminishing of pain and paresthesias in the treated subject. 
     
     
         10 . The method of  claim 9 , wherein the diminishing of pain and paresthesias is accompanied by a decrease of the internal carpal tunnel (CT) pressure and a lessening of the entrapment of the median nerve within the CT. 
     
     
         11 . The method of  claim 1 , wherein treatment is repeated over a period of time as needed by the patient being treated. 
     
     
         12 . The method of  claim 3 , wherein the botulinum toxin is administered in two or more equal injections. 
     
     
         13 . The method of  claim 12 , wherein the botulinum toxin is administered in three equal injections. 
     
     
         14 . The method of  claim 1 , wherein the botulinum toxin is a type B toxin. 
     
     
         15 . The method of  claim 14 , wherein the botulinum toxin type B is Myobloc™. 
     
     
         16 . The method of  claim 15 , wherein the total amount of Myobloc™ injected is up to 10,000 units. 
     
     
         17 . The method of  claim 16 , wherein the total amount of Myobloc™ injected is between about 2500-7500 units. 
     
     
         18 . The method of  claim 1 , wherein the botulinum toxin is a type A toxin. 
     
     
         19 . The method of  claim 18 , wherein the botulinum toxin type A is Botox™. 
     
     
         20 . The method of  claim 19 , wherein the total amount of Botox™ injected is up to 200 units. 
     
     
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