Botulinum toxin in the treatment of myofascial pain syndrome

Pain. 1994 Oct;59(1):65-69. doi: 10.1016/0304-3959(94)90048-5.


Six patients with chronic myofascial pain syndrome involving cervical paraspinal and shoulder girdle muscles received trigger point injections of botulinum toxin type A (Botox) or saline in a randomized, double-blind, placebo-controlled study. Four patients experienced reduction in pain of at least 30% following Botox, but not saline, injections, as measured by visual analog scales, verbal descriptors for pain intensity and unpleasantness, palpable muscle firmness, and pressure pain thresholds. Results were statistically significant. Botox, which inhibits muscle contraction by blocking the release of acetylcholine from peripheral nerves, appears to be an effective treatment for focal myofascial pain disorders.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Botulinum Toxins / administration & dosage
  • Botulinum Toxins / therapeutic use*
  • Chronic Disease
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Myofascial Pain Syndromes / drug therapy*
  • Myofascial Pain Syndromes / physiopathology
  • Pain Measurement
  • Pain Threshold / physiology
  • Spasm / physiopathology


  • Botulinum Toxins