New advances in botulinum toxin therapy for pain.
Myofascial pain syndrome is a chronic pain syndrome that affects a focal or regional portion of the body, accompanied by manifestations of neuropathy. The main treatment goal is to desensitize supersensitive structures and restore motion and function, releasing muscle shortening and promoting healing. Therapeutic approach include MTP injections using botulinum toxin type A and stretch, treatment of psychological or behavioral abnormalities, physical therapy, electrical stimulation and massage. Spasticity is defined as a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex. This physiological events resulted in uncontrolled reflex activity (spasms) and increased muscle tone (rigidity). When used as part of an integrated antispasticity program, the dose of botulinum toxin type A may be adjusted to provide the precise degree of weakness needed to overcome spasticity, while preserving some strength for normal function. The benefits botulinum toxin type A can offer any particular patient depend on the location and degree of spasticity, but improvements in daily activities are usually obtained. In conclusion, botulinum toxin is currently an alternative to consider in the treatment of pain associated with myofascial pain syndrome and/or spasticity, based on a correct diagnosis and patient schedule program.
De Andrés
Jose
J
Department of Anesthesia, Valencia University General Hospital, Avda Tres Cruces s/n, 46014-Valencia, Spain. deandres_jos@gva.es