Shoulder and Neck Pain Relief with Botox in Myofascial Pain Syndrome

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botox for shoulder and neck pain myofascial pain syndromeBotox injections have long been used to relax muscles that are associated with frown lines and deep wrinkles, and such injections have also been found helpful in treating neck pain, headaches, and other types of pain connected to underlying muscles tension.

Myofascial pain is a condition where muscle pain and stiffness are typically centred on certain trigger points, and a new study shows that directly injecting Botox into painful muscle groups can effectively relief myofascial pain in the neck and shoulder.


Botox works by blocking the activity of acetylcholine and thereby causing an antinociceptive effect that inhibits pain signal transmission and relaxes muscles for a prolonged period. Over time, the Botox is degraded and eliminated from the injection site and then the body, with injections needing to be repeated to sustain the effect. For some, a resistance to the effects of Botox can occur, rendering subsequent injections ineffective.

This latest study involved 114 patients with cervical and shoulder girdle myofascial pain. These patients were treated with injections of Botulinum toxin-A (BoNT-A) and the 54 who responded to the treatment were then enrolled in a 12-week trial to further assess the benefits of this therapy. The trial was randomised, placebo-controlled, and double-blind, meaning that neither the researchers nor the patients knew if they were receiving the Botox injections or a placebo.

Reduced Pain and Headaches, Better Sleep with Botox

Patients were assessed before treatment and at follow-up visits up until 26 weeks for measures of pain and quality of life. Those receiving a second Botox injection for neck and shoulder pain had improved average pain scores on a visual scale compared to the controls. Botox injections also reduced the incidence of headaches in these patients, and lowered scores on the Brief Pain Inventory for interference with general activity and sleep.

As such, Botox injections for myofascial pain in the neck and shoulder girdle appear effective for pain relief when the injections are administered in painful muscle groups in those who respond to injections. This offers people with neck and shoulder pain caused by myofascial pain syndrome a longer-lasting option for relief than daily analgesics.

Nicol AL, Wu II, Ferrante FM. Botulinum toxin type a injections for cervical and shoulder girdle myofascial pain using an enriched protocol design. Anesth Analg. 2014 Jun;118(6):1326-35.

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