• O Günther and N Bitterlich.
• Regionales Schmerzzentrum der DGS e.V. Magdeburg.
• MMW Fortschr Med. 2011 Jul 21; 153 Suppl 2: 64-9.

BackgroundMyofascial pain syndrome (MPS) is characterised by acute and chronic pain of the muscles and neighbouring tendons and fasciae. A chronification of the symptoms can take place quite rapidly or develop over years, depending on the individual disposition. Since the mid-nineties, the treatment of MPS with botulinum toxin A (BoNT-A) has gained more importance, especially in cases where conservative therapies were not efficient.MethodsIn this single centre observation, 384 patients with chronified MPS were analysed. Inclusion criteria were previous unsuccessful conventional therapies and a disease and pain duration of at least 6 months. One vial with 500 units BoNT-A (Dysport) was applied with the injection points chosen individually for each patient. Effectiveness of the therapy was assessed on the basis of change in pain intensity as measured on a 10 cm gradual Visual Analogue Scale (VAS). The pain pressure threshold was also determined for 227 patients.ResultsOne week after injection, pain intensity was reduced for nearly half of the patients (47.4%) by more than 2 score points versus baseline. This percentage increased to 86.1% of the patients up to the next visit six weeks after treatment. Six weeks after injection, a decrease of pain intensity could be observed in 368 of the 384 patients (95%). Only 11 patients judged their pain intensity as unchanged or even worse.The pain pressurethreshold increased bya median value of 0.6 (pt < 0.001) from one week after treatment up to the last visit 6 weeks following treatment.ConclusionBoNT-A, appropriately administered, is an effective and safe therapy option in the treatment of MPS. For the effective treatment of MPS, concomitant physiotherapy with different therapeutical options must be applied in order to compensate for muscular imbalances.

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