Toxina botulínica tipo A para el manejo del dolor en pacientes con síndrome de dolor miofascial crónico

Abstract

Introduction Myofascial syndrome is one of the main chronic pain syndromes encountered in clinical practice and is commonly associated with trauma or repetitive microtrauma. Botulinum toxin type A (Botox ®) is an accepted therapeutic option. Objective To evaluate the use of botulinum toxin type A (Botox ®), infiltrated in trigger points, as an option in the management of pain in patients with chronic myofascial syndrome. Material and Methods Thirty men and women with myofascial pain syndrome, aged between 25 and 50 years were included. In all patients, botulinum toxin type A (Botox ®) was infiltrated in trigger points by means of electrosonomyographic equipment. A dilution of 100 Um toxin in 1 cc saline solution was used and a total of 200 to 400 Um was administered depending on the site of the pain. Analgesic quality was evaluated through a Visual Analog Scale (VAS) and the disability index was evaluated with the Oswestry questionnaire over 4 weeks. Results The mean initial VAS score was 7.23 and the mean final score was 3.13 (p < 0.01). The mean initial Oswestry index was 67.7%, decreasing to 35.5% at the end of the study (p < 0.0001). Conclusions The application of botulinum toxin type A in patients with postsurgical myofascial syndrome is effective in reducing pain intensity and in improving disability and quality of life.