Botulinum toxin in the treatment of myofascial pain

It has been hypothesized that botulinum toxin (BTX) might offer an advantage over conventional treatments for myofascial syndrome. We tested the long-term effect of BTX in the treatment of myofascial pain related to the head and neck (group 1, n = 33) and low back (group 2, n = 19). Measurements were obtained at baseline and at 4-week intervals for up to 6 months after BTX treatment. Variables included pain level, spasm level, patient satisfaction level, medication usage and the incidence of side-effects. Low-dose injection using BTX (10-300 units/treatment) was effective in ameliorating symptoms in this patient population. We documented a greater than 50 per cent reduction in spasm level and an improved response to treatment in 63 and 43 per cent of patients in groups 1 and 2, respectively. Side-effects, such as flu-like symptoms and nausea, were reported by 62 per cent of patients after the first treatment, but resolved within 1 week.