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Trigger Point Injection with BOTOX

Posted on: 01/24/2008
Myofascial pain syndrome (MPS) is a common cause of neck and back pain. In this condition, tight muscles with increased tone or tension result in trigger points (TrPs).

Trigger points are defined as tender points in the muscle that trigger or set off a pain pattern in the affected area. This could be anywhere in the body including the neck and back.

In this study, scientists at Stanford University report on the use of botulinum toxin type A (BTX-A). Another well-known name for botulinum toxin is BOTOX. Patients in this study had neck and upper back pain from MPS.

Two groups of patients with MPS were compared. The treatment group received one injection of BTX-A in TrPs of up to two muscles. Specific TrPs were injected based on palpation of tender points.

The control group received a saline (salt water) injection as a placebo. Placebo means the injection has no known effect but the person believes it works and gets better because of it.

Results were measured based on neck pain, body pain, function, and disability. The treatment group reported decreased bodily pain and improved mental health. The greatest improvement was seen at two and four months after injection.

Changes in neck pain were not different between the two groups. Both groups had less neck pain after injection. There were no differences in post-injection side effects or problems between the two groups.

The authors point out that both groups seemed to experience a placebo analgesia effect. This was the interpretation of the results since both groups had decreased neck pain and disability.

The results of other studies have led some experts to conclude the pinprick from the needle is what makes the treatment successful. Future studies are needed to target other areas of the muscles. Results should be compared to patients in a control group and patients receiving a TrP injection.

Henry L. Lew, MD, PhD, et al. Therapeutic Use of Botulinum Toxin Type A in Treating Neck and Upper-Back Pain of Myofascial Origin: A Pilot Study. In Archives of Physical Medicine and Rehabilitation. January 2008. Vol. 89. No. 1. Pp. 75-80.

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