What is the role of botulinum toxin (BTX) injection for pain management in muscle spasticity?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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BTX-A has been demonstrated to reduce pain in muscle spasticity and has been applied to treat more common painful disorders such as headache, neck pain, and back pain. The beneficial effect attributed to BTX is thought to be due to in part to its capacity to reduce painful muscle contraction or spasm; therefore, research continues determine whether it can be used as an effective intervention for myofascial pain disorders, which has been studied extensively, but remains controversial and poorly understood.

Wissel et al investigated the effects of BTXA injections in 60 patients with pain due to acute and chronic spasticity in a prospective multicenter study. [88] Baseline and follow-up (mean 5.9 wk) measures included a patient self-assessment of pain and function using a 5-level scale, a physician evaluation of function, and a global rating of response. Fifty-four of sixty patients experienced improvement in pain without subjective functional improvement. The effects were comparable in acute (n = 17) and chronic (n = 43) spasticity. No serious adverse event was observed.

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