Botulinum toxin A in the treatment of chronic myofascial pain

Myofascial pain syndrome (MPS) is one of the most common reasons for chronic pain in clinical practice. The most prominent finding is the so called trigger point, a muscular contraction knot which leads to local and referred pain patterns. Pathophysiologically there is on underlying dysfunction of the neuromuscular endplate which is caused by a specific muscular overload, MPS is often underdiagnosed and therefore inadequately treated. Besides established therapeutic procedures like physiotherapy (stretching techniques, "spray and stretch"), oral muscle relaxants and analgesics, dry needling and local injection techniques (local anesthetics, steroids) the use of botulinum toxin A (BTX-A) is an innovative and causal acting therapeutic strategy with a long lasting effect which can lead to a sufficient rehabilitation of the affected patient.