Botulinum toxin type A (Botox) injections may help ease pain and improve quality of life in patients suffering from chronic bilateral posterior neck and shoulder myofascial pain syndrome, according to a study.
Traditional therapies for the treatment of myofascial pain syndrome include medications such as anti-inflammatory drugs (such as ibuprofen or naproxen), steroids and muscle relaxants, physical therapy and behavioral modification.
"At best, long-term benefit with traditional therapies is transient and unpredictable," said Andrea L. Nicol, M.D., M.S., Director of Research - UCLA Pain Management Center, Assistant Clinical Professor, Department of Anesthesiology - Division of Pain Management, David Geffen School of Medicine at UCLA. "Even with these treatments, some people with myofascial pain syndrome get incomplete benefit or no benefit at all."
BOTOX is used commercially to treat multiple painful medical conditions, including migraine headaches, spasticity and cervical dystonia. It is also used cosmetically as a means of reducing the appearance of frown lines and wrinkles.
"BOTOX is in a class of medications called neurotoxins and when injected into muscles, blocks the nerve signals that cause the tightening of muscle, leading to muscle relaxation. Thus, BOTOX may offer advantages over traditional therapies for myofascial pain syndrome due to its prolonged and sustained effects," Dr. Nicol confirmed.
The study was conducted at the University of California, Los Angeles by Chronic Pain Management Specialists F. Michael Ferrante, M.D. and Andrea Nicol, M.D. All subjects who enrolled in the study were given injections of BOTOX into the painful muscles of the neck and shoulder area during the first phase of the study. Subjects with significant improvement to BOTOX treatment moved on to the second phase of the study and were randomized into two groups. Subjects in the treatment group had BOTOX injections into the painful muscles of the neck and shoulder area. Subjects in the control group received a placebo injection (salt water) into the painful muscles of the neck and shoulder.
Those enrolled in the study were monitored intermittently to assess their response to the injections. Pain scales and questionnaires were administered to document response and perform data analysis.
Analysis of the results revealed subjects who received BOTOX injections had:
• A significantly greater reduction of their pain scores compared to those subjects who had received placebo injections.
• A significant reduction in the number of headaches they experienced on a weekly basis.
• The severity of the subjects' headaches (numerical pain score rating) was reduced.
• A significant reduction in the interference of their pain with regards to general activity, sleep and enjoyment, indicating an overall improved quality of life.
Given the findings of this study, BOTOX may be an option for those who have been suffering with myofascial pain syndrome and have yet to find relief with traditional therapies.