Botulinum toxin for the treatment of musculoskeletal pain and spasm

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Chadlkiadaki A, Rohr UP, Hefter H: Early pain reduction in the treatment of spasticity after a single injection of botulinum A toxin. Deutsch Med Wochenschr 2001, 126:1361–1364.

Giladi N: The mechanism of action of botulinum toxin type A in focal dystonia is most probably through its dual effect on efferent (motor) and afferent pathways at the injected site. J Neurol Sci 1997, 152:132–135.

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Foster L, Clapp L, Erickson M, Jabbari B: Botulinum toxin A and chronic low back pain: a randomized, double-blind study. Neurology 2001, 56:1290–1293. This is the only controlled study of botulinum toxin in the treatment of low back pain. Patients receiving botulinum toxin-A obtained greater pain relief and improved function compared with the placebo group. Although only 31 patients were observed, the results are encouraging.

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Wheeler AH, Goolkasian P, Gretz SS: Botulinum toxin A for the treatment of chronic neck pain. Pain 2001, 94:255–260. A study including 50 patients that showed no benefit of botulinum toxin type A injections.

Borg-Stein J, Simons DG: Myofascial pain. Arch Phys Med Rehabil 2002, 83(suppl 1):S40-S47. An excellent summary of myofascial pain syndrome, with detailed discussion of the pathophysiology.

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Wheeler AH, Goolkasian P, Gretz SS: A randomized, doubleblind, prospective pilot study of botulinum toxin injection for refractory, unilateral, cervicothoracic, paraspinal, myofascial pain syndrome. Spine 1998, 23:1662–1666.

Porta M: A comparative trial of botulinum toxin type A and methylprednisolone for the treatment of myofascial pain syndrome and pain from chronic muscle spasm. Pain 2000, 85:101–105.

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Asherson RA, Pascoe LP: The use of botulinum toxin-A in the treatment of patients with fibromyalgia. J Rheumatol 2001, 28:1740. A trial of fibromyalgia, but trigger points were injected. This trial involved open-label injections of botulinum toxin type A, often in multiple sessions. All 16 patients reportedly responded well, with benefit lasting for 16 weeks.

Morre HH, Keizer SB, van Os JJ: Treatment of chronic tennis elbow with botulinum toxin. Lancet 1997, 349:1746.

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Bluthner M, Haugke C, Kalischewski P: The treatment of lateral epicondylitis elbow with botulinum toxin A: a first experience. Abstracts of the International Conference 2002: Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins. Arch Pharmacol 2002, 365:R14.

Placzek R, Meiss L: Temporary chemical denervation with botulinum toxin A in epicondylitis radialis: a therapy trial in 14 patients. Abstracts of the International Conference 2002: Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins. Arch Pharmacol 2002, 365:R34.

Kehl LJ, Trempe TM, Hargreaves KM: A new animal model for assessing mechanisms and management of muscle hyperalgesia. Pain 2000, 85:333–343.

Thunberg J, Ljubisavljevic M, Djupsjobacka M, Johansson H: Effects on the fusimotor-muscle spindle system induced by intramuscular injections of hypertonic saline. Exp Brain Res 2002, 142:319–326.

Graven-Nielsen T, Mense S: The peripheral apparatus of muscle pain: evidence from animal and human studies. Clin J Pain 2001, 17:2–10. An excellent review of the pathophysiologic mechanisms of acute and chronic muscle pain.

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Svensson P, Graven-Nielsen T, Matre D, Arendt-Nielsen L: Experimental muscle pain does not cause long-lasting increases in resting electromyographic activity. Muscle Nerve 1998, 21:1382–1389.

Cui M, Aoki R: Botulinum toxin A (BTX-a) reduces inflammatory pain in the rat formalin model. Cephalalgia 2000, 20:414–0.

Schulte-Matler WJ, Blersch W, Przywara S, et al.: Botulinum toxin A and the cutaneous nociception in humans. Abstracts of the International Conference 2002: Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins. Arch Pharmacol 2002, 365:R39.

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Cui M, Li Z, You S, Khanijou S, Aoki R: Mechanisms of the antinociceptive effect of subcutaneous Botox": inhibition of peripheral and central nociceptive processing. Abstracts of the International Conference 2002: Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins. Arch Pharmacol 2002, 365:R17. Another important finding in the search for the mechanism of the analgesic action of botulinum toxin type A. Peripheral glutamate levels were reduced and central sensitization was prevented as a result.

Ishikawa H, Mitsui Y, Yoshitomi T, et al.: Presynaptic effects of botulinum toxin type A on the neuronally evoked response of albino and pigmented rabbit iris sphincter and dilator muscles. Jpn J Ophthalmol 2000, 44:106–109.

Morris JL, Jobling P, Gibbins IL: Differential inhibition by botulinum neurotoxin A of cotransmitters released from autonomic vasodilator neurons. Am J Physiol Heart Circ Physiol 2001, 281:2124–2132.

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Jung HH, Lauterburg T, Burgunder JM: Expression of neurotransmitter genes in rat spinal motoneurons after chemodenervation with botulinum toxin. Neuroscience 1997, 78:469–479.

Humm AM, Pabst C, Lauterburg T, Burgunder JM: Enkephalin and aFGF are differentially regulated in rat spinal motoneurons after chemodenervation with botulinum toxin. Exp Neurol 2000, 161:361–372.

Heinricher MM, McGaraughty S, Tortorici V: Circuitry underlying antiopioid actions of cholecystokinin within the rostral ventromedial medulla. J Neurophysiol 2001, 85:280–286.

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Duggan MJ, Quinn CP, Chaddock JA, et al.: Inhibition of release of neurotransmitters from rat dorsal root ganglia by a novel conjugate of a Clostridium botulinum toxin A endopeptidase fragment and Erythrina cristagalli lectin. J Biol Chem 2002, in press.