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

摘要

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.