Botulinum toxin for the treatment of myofascial pain syndromes involving the neck and back: A review from a clinical perspective

José M. Climent, Ta Shen Kuan, Pedro Fenollosa, Francisco Martin-Del-Rosario

Research output: Contribution to journalReview articlepeer-review

19 Citations (Scopus)


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.

Original languageEnglish
Article number381459
JournalEvidence-based Complementary and Alternative Medicine
Publication statusPublished - 2013

All Science Journal Classification (ASJC) codes

  • Complementary and alternative medicine


Dive into the research topics of 'Botulinum toxin for the treatment of myofascial pain syndromes involving the neck and back: A review from a clinical perspective'. Together they form a unique fingerprint.

Cite this