title: Botulinum toxin type A and myofascial pain syndrome: a retrospective study of 301 patients.
abstract: BACKGROUND
  Botulinum toxin type A (BTX-A) intramuscular injections have been used for the treatment of myofascial pain syndrome (MPS), although its efficacy remains still unknown and its safety is controversial.
  
  
  OBJECTIVE
  To analyze the effectiveness and safety of the injection protocol for BTX-A in the shoulder-scapular and lumbar-pelvic girdles combined with physiotherapy in patients with primary and secondary MPS.
  
  
  METHODS
  Retrospective descriptive study including 301 medical files of patients with persistent MPS. Positive responses to treatment were considered to be a satisfactory level of effectiveness with 50% pain relief or a fully satisfactory level of effectiveness at 80%.
  
  
  RESULTS
  Overall, 58.1% of patients obtained a positive result at 6 months. Differences in effectiveness were found between primary MPS (82.9% of patients) and secondary MPS (54.9%; p=0.002). In patients with secondary MPS, differences in effectiveness arose based on pathologies associated with MPS (p=0.03). In 23.9% of cases, mild and temporary adverse effects were observed post-infiltration.
  
  
  CONCLUSIONS
  BTX-A injections and physiotherapy is an alternative to conventional treatment which should be considered when treating refractory MPS. Nonetheless, the differences in effectiveness based on diagnosis suggest the need to clarify the criteria used to select patients with MPS in future clinical trials and applications.
authors.affiliation: E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla-La Mancha, Toledo, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Avendaño-Coy
authors.affiliation: E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla-La Mancha, Toledo, Spain Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Gómez-Soriano
authors.affiliation: Departamento de Enfermería y Fisioterapia, Universidad de León, León, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Valencia
authors.affiliation: Chronic Pain Unit, Departamento de Anestesiología del Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Estrada
authors.affiliation: Chronic Pain Unit, Departamento de Anestesiología del Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Leal
authors.affiliation: Chronic Pain Unit, Departamento de Anestesiología del Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Ruiz-Campa
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D063806:Myalgia / Q000139:chemically induced / Q000453:epidemiology; D009209:Myofascial Pain Syndromes / Q000188:drug therapy*; D010243:Paralysis / Q000139:chemically induced / Q000453:epidemiology; D026741:Physical Therapy Modalities; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin type A; adverse effects; myofascial pain syndromes