Revisión sistemática: ¿es recomendable el empleo de toxina botulínica como tratamiento del dolor en el síndrome miofascial?

Pereda, Claudia Alejandra; Jaeger, Jacqueline Usón; Carmona, Loreto

doi:10.1016/s1699-258x(06)73043-1

Cited by 8 publications

(1 citation statement)

References 31 publications

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“…Another group of reviewers concluded that the available data were not sufficiently strong either to recommend or to reject the use of botulinum toxin in MPS [51, 59]. In another review, this conclusion was expressed differently, stating that the efficacy remains unproven [56].…”

Section: Systematic Reviewsmentioning

confidence: 99%

Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

Climent

Kuan

Fenollosa³

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

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Section: Systematic Reviewsmentioning

confidence: 99%

Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

Climent

Kuan

Fenollosa³

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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Botulinum toxin for myofascial pain syndromes in adults

Soares

Andriolo

Atallah

et al. 2014

Cochrane Database of Systematic Reviews

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Since the first publication of this review, no new studies were found. There is inconclusive evidence to support the use of botulinum toxin in the treatment of MPS based on data from four studies with a total of 233 participants, which we considered were of sufficient quality to be included in this review. Meta-analyses were not possible due to the heterogeneity between studies. We suggest that in future studies the same methodology to assess pain, a standardised dose of treatment, follow-up of at least four months (to observe the maximum and minimum curve of the drug effect) and appropriate data presentation should be used. More high-quality RCTs of botulinum toxin for treating MPS need to be conducted before firm conclusions on its effectiveness and safety can be drawn.

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