Pain Reduction with Repeated Injections of Botulinum Toxin A in Upper Limb Spasticity: A Longitudinal Analysis from the ULIS-III Study.

In addition, there was a clear trend towards a progressive reduction in pain scores both at the start and end of each cycle, suggesting some cumulative effect of repeated injection on pain over 2 years.

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Response to Repeated Injections Although the magnitude of response with each injection tended to diminish slightly over successive cycles and repeated-measures ANOVAs were borderline significant, the effect sizes between cycles were small (0.01–0.13; see Table 2 c) and therefore unlikely to be clinically significant.

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