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Anne Asher

Botox for Trigger Points?

By November 16, 2012

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Trigger points are the mark of a condition known as myofascial pain syndrome or MPS. Enduring a lot of these hard little nodules can be quite a bear. Not only do they limit motion in the area, but they affect places afar, as well. Trigger points quite often refer pain to other places in the body (yes, they do have specific patterns, according to the muscle in which they reside). Not only that, but the restriction that comes from trigger points can have effects up or down the kinetic chain, which may further limit your physical functionality. And cause more pain.

Many people take care of their trigger points by seeing a massage therapist who has skills in this area.    If you're interested in taking the natural route, you might look for a neuromuscular therapist. Neuromuscular therapists are massage therapists trained to work with trigger points as well as other biomechanical and postural issues.

Just the same, conventional medical treatment for trigger points does exist.

Standard treatment for trigger points is an injection.  Injected medications types vary, but they include bupivacaine, etidocaine, lidocaine, saline, or sterile water. Sometimes steroid medication is used.

And don't forget Botox.  Botox, the wrinkle treatment many women rave about is gaining traction (at least in the popular media, and among lay people) as a pain medication. Botox is thought to work by stopping muscles from chronically contracting.

But does it really work? Can you have your doctor inject your trigger points with botox and expect the pain to go away? The Cochrane Library reviewed studies that addressed this very question. The review included 4 studies, 233 subjects and looked at injections for trigger points all over the body except in the neck or head.

The reviewers found no evidence that Botox has an effective medication for trigger points.  They did  suggest more high quality studies be done to clearly determine the safety and effectiveness profile of Botox for trigger point pain relief.


Soares A, Andriolo RB, Atallah AN, da Silva EM. Botulinum toxin for myofascial pain syndromes in adults. Cochrane Database Syst Rev. 2012 Apr 18;4:CD007533.

Finley, J, MD, et. al. Physical Medicine and Rehabilitation for Myofascial Pain Workup. Medscape Reference: Drugs, Diseases and Procedures. http://emedicine.medscape.com/article/313007-workup#a0722


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