Use of Botulinum Toxin in the Treatment of Chronic Myofascial Pain

Andrés, José De; Cerdá-Olmedo, Germán; Valía, Juan Carlos; Monsalve, V.; Lopez-Alarcon,; Mínguez, A.

doi:10.1097/00002508-200307000-00011

Cited by 75 publications

(29 citation statements)

References 38 publications

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“…A number of open label and retrospective studies have been done to assess the usefulness of BoNTA in treating this condition. The preliminary results were encouraging as Botox was shown to be effective in relieving pain (Lang 2000;De Andrés et al 2003;Wheeler et al 2001a;Royal et al 2001). However, these findings have not been confirmed by RCTs.…”

Section: Msk Pain Disordersmentioning

confidence: 99%

The efficacy of botulinum toxin type A in managing chronic musculoskeletal pain: a systematic review and meta analysis

et al. 2010

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In our meta-analysis, BoNTA had a small to moderate analgesic effect in chronic musculoskeletal pain conditions. It was particularly effective in plantar fasciitis, tennis elbow, and back pain, but not in whiplash or shoulder pain patients. However, more evidence is required before definitive conclusions can be drawn. On the other hand, there is convincing evidence that BoNTA lacks strong analgesic effects in patients with myofascial pain syndrome. A general dose-dependent and temporal response with BoNTA injections was also observed.

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Section: Msk Pain Disordersmentioning

confidence: 99%

The efficacy of botulinum toxin type A in managing chronic musculoskeletal pain: a systematic review and meta analysis

et al. 2010

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“…In these studies, BT was injected intramuscularly into painful trigger points under electromyographic guidance for neck-shoulder myofascial pain syndromes [25,26,28] while CT or fluoroscopic guidance was utilized for deeper muscles such as iliopsoas, quadratus lumborum or piriformis [5,27]. The encouraging findings of these investigations have led to the use of BT in other syndromes where the specific goal is relief of pain, such as neuropathic pain or temporomandibular dysfunction [29,30].…”

Section: Introductionmentioning

confidence: 99%

Botulinum toxin injection to facilitate rehabilitation of muscle imbalance syndromes in sports medicine

Cullen¹,

Boyle

Silbert

et al. 2007

Disability and Rehabilitation

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Intramuscular injection of Botulinum toxin to produce reduction of focal muscle overactivity, and localized muscle spasm, has been utilized therapeutically for almost two decades. Muscle overactivity in neurologically normal muscle, where an imbalance exists between a relatively overactive muscle and its less active synergist or antagonist, can inhibit control of the antagonist producing a functional muscle imbalance. This brief review provides an overview of the role of muscle imbalance in sports-related pain and dysfunction, and outlines the potential for intramuscular injection of Botulinum toxin to be used as an adjunct to specific muscle re-education and functional rehabilitation in this patient group. A comprehensive understanding of normal movement and the requirements of the sporting activity are essential to allow accurate diagnosis of abnormal motor patterns and to re-educate more appropriate movement strategies. Therapeutic management of co-impairments may include stretching of tight soft tissues, specific re-education aimed at isolation of the non-dominant weak muscles and improvement in their activation, 'unlearning' of faulty motor patterns, and eventual progression onto functional exercises to anticipate gradual return to sporting activity. Intramuscular injection of Botulinum toxin, in carefully selected cases, provides short term reduction of focal muscle overactivity, and may facilitate activation of relatively 'inhibited' muscles and assist the restoration of more appropriate motor patterns.

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“…80 Several other studies have also shown that the administration of botulinum toxin can reduce the activity of trigger points. [81][82][83][84][85][86][87] Therefore, trigger points are found in close vicinity of motor endplates, which are spread out throughout the entire muscle. [88][89][90] Active trigger points are clustered around motor endplates and feature more endplate noise than latent trigger points, which once again supports that active trigger points are more sensitized.…”

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confidence: 99%

Dry needling — peripheral and central considerations

Dommerholt¹

2011

Journal of Manual & Manipulative Therapy

221

140

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Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive input leading to peripheral and central sensitization. Dry needling cannot only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points. Trigger point dry needling should be based on a thorough understanding of the scientific background of trigger points, the differences and similarities between active and latent trigger points, motor adaptation, and central sensitize application. Several outcome studies are included, as well as comments on dry needling and acupuncture.

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Use of Botulinum Toxin in the Treatment of Chronic Myofascial Pain

Cited by 75 publications

References 38 publications

The efficacy of botulinum toxin type A in managing chronic musculoskeletal pain: a systematic review and meta analysis

The efficacy of botulinum toxin type A in managing chronic musculoskeletal pain: a systematic review and meta analysis

Botulinum toxin injection to facilitate rehabilitation of muscle imbalance syndromes in sports medicine

Dry needling — peripheral and central considerations

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