Advertisement

Myofascial Pain Syndrome Treatments

Published:March 20, 2014DOI:https://doi.org/10.1016/j.pmr.2014.01.012

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Physical Medicine and Rehabilitation Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Simons D, Travell J, Simons L. Myofascial Pain and Dysfunction: The Trigger Point Manual, Vol. 1. Upper Half of Body. Baltimore (MD): Williams & Wilkins; 1999.

        • Borg-Stein J.
        • Simons D.G.
        Focused review: myofascial pain.
        Arch Phys Med Rehabil. 2002; 83 (S48–9): S40-S47
        • Borg-Stein J.
        Treatment of fibromyalgia, myofascial pain, and related disorders.
        Phys Med Rehabil Clin N Am. 2006; 17 (viii): 491-510
        • Fleckenstein J.
        • Zaps D.
        • Ruger L.J.
        • et al.
        Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey.
        BMC Musculoskelet Disord. 2010; 11: 32
        • Gerwin R.D.
        Classification, epidemiology, and natural history of myofascial pain syndrome.
        Curr Pain Headache Rep. 2001; 5: 412-420
        • Rollman G.B.
        • Lautenbacher S.
        Sex differences in musculoskeletal pain.
        Clin J Pain. 2001; 17: 20-24
        • Fricton J.R.
        • Kroening R.
        • Haley D.
        • et al.
        Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients.
        Oral Surg Oral Med Oral Pathol. 1985; 60: 615-623
        • Krabak B.J.
        • Borg-Stein J.
        • Oas J.A.
        Chronic cervical myofascial pain syndrome: improvement in dizziness and pain with a multidisciplinary rehabilitation program. A pilot study.
        J Back Musculoskelet Rehabil. 2000; 15: 83-87
        • Altindag O.
        • Gur A.
        • Altindag A.
        The relationship between clinical parameters and depression level in patients with myofascial pain syndrome.
        Pain Med. 2008; 9: 161-165
        • Dohrenwend B.P.
        • Raphael K.G.
        • Marbach J.J.
        • et al.
        Why is depression comorbid with chronic myofascial face pain? A family study test of alternative hypotheses.
        Pain. 1999; 83: 183-192
        • Schwartz R.A.
        • Greene C.S.
        • Laskin D.M.
        Personality characteristics of patients with myofascial pain-dysfunction (MPD) syndrome unresponsive to conventional therapy.
        J Dent Res. 1979; 58: 1435-1439
        • Hong C.
        Muscle pain syndromes.
        in: Braddom R. Physical medicine and rehabilitation. WB Saunders, Philadelphia2011: 971-1002
        • Bron C.
        • Dommerholt J.
        • Stegenga B.
        • et al.
        High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain.
        BMC Musculoskelet Disord. 2011; 12: 139
        • Couppe C.
        • Torelli P.
        • Fuglsang-Frederiksen A.
        • et al.
        Myofascial trigger points are very prevalent in patients with chronic tension-type headache: a double-blinded controlled study.
        Clin J Pain. 2007; 23: 23-27
        • Fernandez-Carnero J.
        • Fernandez-de-Las-Penas C.
        • de la Llave-Rincon A.I.
        • et al.
        Prevalence of and referred pain from myofascial trigger points in the forearm muscles in patients with lateral epicondylalgia.
        Clin J Pain. 2007; 23: 353-360
        • Rashiq S.
        • Galer B.S.
        Proximal myofascial dysfunction in complex regional pain syndrome: a retrospective prevalence study.
        Clin J Pain. 1999; 15: 151-153
        • Itza F.
        • Zarza D.
        • Serra L.
        • et al.
        Myofascial pain syndrome in the pelvic floor: a common urological condition.
        Actas Urol Esp. 2010; 34: 318-326
        • Qerama E.
        • Kasch H.
        • Fuglsang-Frederiksen A.
        Occurrence of myofascial pain in patients with possible carpal tunnel syndrome–a single-blinded study.
        Eur J Pain. 2009; 13: 588-591
        • Diaz J.H.
        • Gould 3rd, H.J.
        Management of post-thoracotomy pseudoangina and myofascial pain with botulinum toxin.
        Anesthesiology. 1999; 91: 877-879
        • Fernandez-Lao C.
        • Cantarero-Villanueva I.
        • Fernandez-de-Las-Penas C.
        • et al.
        Development of active myofascial trigger points in neck and shoulder musculature is similar after lumpectomy or mastectomy surgery for breast cancer.
        J Bodyw Mov Ther. 2012; 16: 183-190
        • Hamada H.
        • Moriwaki K.
        • Shiroyama K.
        • et al.
        Myofascial pain in patients with postthoracotomy pain syndrome.
        Reg Anesth Pain Med. 2000; 25: 302-305
        • Karmakar M.K.
        • Ho A.M.
        Postthoracotomy pain syndrome.
        Thorac Surg Clin. 2004; 14: 345-352
        • Goldenberg D.L.
        • Felson D.T.
        • Dinerman H.
        A randomized, controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia.
        Arthritis Rheum. 1986; 29: 1371-1377
        • Fossaluzza V.
        • De Vita S.
        Combined therapy with cyclobenzaprine and ibuprofen in primary fibromyalgia syndrome.
        Int J Clin Pharmacol Res. 1992; 12: 99-102
        • Russell I.J.
        • Fletcher E.M.
        • Michalek J.E.
        • et al.
        Treatment of primary fibrositis/fibromyalgia syndrome with ibuprofen and alprazolam. A double-blind, placebo-controlled study.
        Arthritis Rheum. 1991; 34: 552-560
        • Singer E.
        • Dionne R.
        A controlled evaluation of ibuprofen and diazepam for chronic orofacial muscle pain.
        J Orofac Pain. 1997; 11: 139-146
        • Castelnuovo E.
        • Cross P.
        • Mt-Isa S.
        • et al.
        Cost-effectiveness of advising the use of topical or oral ibuprofen for knee pain; the TOIB study [ISRCTN: 79353052].
        Rheumatology (Oxford). 2008; 47: 1077-1081
        • Hsieh L.F.
        • Hong C.Z.
        • Chern S.H.
        • et al.
        Efficacy and side effects of diclofenac patch in treatment of patients with myofascial pain syndrome of the upper trapezius.
        J Pain Symptom Manage. 2010; 39: 116-125
        • Frontera W.
        • DeLisa J.
        • Gans B.
        • et al.
        Delisa’s physical medicine and rehabilitation principles and practice.
        Lippincott Williams & Wilkins, Philadelphia2010
        • Herman C.R.
        • Schiffman E.L.
        • Look J.O.
        • et al.
        The effectiveness of adding pharmacologic treatment with clonazepam or cyclobenzaprine to patient education and self-care for the treatment of jaw pain upon awakening: a randomized clinical trial.
        J Orofac Pain. 2002; 16: 64-70
        • Leite F.M.
        • Atallah A.N.
        • El Dib R.
        • et al.
        Cyclobenzaprine for the treatment of myofascial pain in adults.
        Cochrane Database Syst Rev. 2009; (CD006830)
        • Ono H.
        • Mishima A.
        • Ono S.
        • et al.
        Inhibitory effects of clonidine and tizanidine on release of substance P from slices of rat spinal cord and antagonism by alpha-adrenergic receptor antagonists.
        Neuropharmacology. 1991; 30: 585-589
        • Hirata K.
        • Koyama N.
        • Minami T.
        The effects of clonidine and tizanidine on responses of nociceptive neurons in nucleus ventralis posterolateralis of the cat thalamus.
        Anesth Analg. 1995; 81: 259-264
        • Davies J.
        Selective depression of synaptic transmission of spinal neurones in the cat by a new centrally acting muscle relaxant, 5-chloro-4-(2-imidazolin-2-yl-amino)-2, 1, 3-benzothiodazole (DS103-282).
        Br J Pharmacol. 1982; 76: 473-481
        • Malanga G.A.
        • Gwynn M.W.
        • Smith R.
        • et al.
        Tizanidine is effective in the treatment of myofascial pain syndrome.
        Pain Physician. 2002; 5: 422-432
        • Berry H.
        • Hutchinson D.R.
        A multicentre placebo-controlled study in general practice to evaluate the efficacy and safety of tizanidine in acute low-back pain.
        J Int Med Res. 1988; 16: 75-82
        • Berry H.
        • Hutchinson D.R.
        Tizanidine and ibuprofen in acute low-back pain: results of a double-blind multicentre study in general practice.
        J Int Med Res. 1988; 16: 83-91
        • Manfredini D.
        • Landi N.
        • Tognini F.
        • et al.
        Muscle relaxants in the treatment of myofascial face pain. A literature review.
        Minerva Stomatol. 2004; 53: 305-313
        • Fishbain D.A.
        • Cutler R.B.
        • Rosomoff H.L.
        • et al.
        Clonazepam open clinical treatment trial for myofascial syndrome associated chronic pain.
        Pain Med. 2000; 1: 332-339
        • Harkins S.
        • Linford J.
        • Cohen J.
        • et al.
        Administration of clonazepam in the treatment of TMD and associated myofascial pain: a double-blind pilot study.
        J Craniomandib Disord. 1991; 5: 179-186
        • Bendtsen L.
        • Jensen R.
        Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache.
        Cephalalgia. 2000; 20: 603-610
        • Plesh O.
        • Curtis D.
        • Levine J.
        • et al.
        Amitriptyline treatment of chronic pain in patients with temporomandibular disorders.
        J Oral Rehabil. 2000; 27: 834-841
        • Annaswamy T.M.
        • De Luigi A.J.
        • O'Neill B.J.
        • et al.
        Emerging concepts in the treatment of myofascial pain: a review of medications, modalities, and needle-based interventions.
        PM R. 2011; 3: 940-961
        • Arnold L.M.
        • Lu Y.
        • Crofford L.J.
        • et al.
        A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder.
        Arthritis Rheum. 2004; 50: 2974-2984
        • Offenbaecher M.
        • Ackenheil M.
        Current trends in neuropathic pain treatments with special reference to fibromyalgia.
        CNS Spectr. 2005; 10: 285-297
        • Sayar K.
        • Aksu G.
        • Ak I.
        • et al.
        Venlafaxine treatment of fibromyalgia.
        Ann Pharmacother. 2003; 37: 1561-1565
        • Khatun S.
        • Huq M.Z.
        • Islam M.A.
        • et al.
        Clinical outcomes of management of myofacial pain dysfunction syndrome.
        Mymensingh Med J. 2012; 21: 281-285
        • Rosenberg M.T.
        The role of tramadol ER in the treatment of chronic pain.
        Int J Clin Pract. 2009; 63: 1531-1543
        • Kean W.F.
        • Bouchard S.
        • Roderich Gossen E.
        Women with pain due to osteoarthritis: the efficacy and safety of a once-daily formulation of tramadol.
        Pain Med. 2009; 10: 1001-1011
        • Schnitzer T.J.
        • Gray W.L.
        • Paster R.Z.
        • et al.
        Efficacy of tramadol in treatment of chronic low back pain.
        J Rheumatol. 2000; 27: 772-778
        • Wilder-Smith C.H.
        • Hill L.
        • Spargo K.
        • et al.
        Treatment of severe pain from osteoarthritis with slow-release tramadol or dihydrocodeine in combination with NSAID's: a randomised study comparing analgesia, antinociception and gastrointestinal effects.
        Pain. 2001; 91: 23-31
        • Affaitati G.
        • Fabrizio A.
        • Savini A.
        • et al.
        A randomized, controlled study comparing a lidocaine patch, a placebo patch, and anesthetic injection for treatment of trigger points in patients with myofascial pain syndrome: evaluation of pain and somatic pain thresholds.
        Clin Ther. 2009; 31: 705-720
        • Lin S.Y.
        • Neoh C.A.
        • Huang Y.T.
        • et al.
        Educational program for myofascial pain syndrome.
        J Altern Complement Med. 2010; 16: 633-640
        • Treaster D.
        • Marras W.S.
        • Burr D.
        • et al.
        Myofascial trigger point development from visual and postural stressors during computer work.
        J Electromyogr Kinesiol. 2006; 16: 115-124
        • Edwards R.H.
        Hypotheses of peripheral and central mechanisms underlying occupational muscle pain and injury.
        Eur J Appl Physiol Occup Physiol. 1988; 57: 275-281
        • Madeleine P.
        On functional motor adaptations: from the quantification of motor strategies to the prevention of musculoskeletal disorders in the neck-shoulder region.
        Acta Physiol (Oxf). 2010; 199: 1-46
        • Hoyle J.A.
        • Marras W.S.
        • Sheedy J.E.
        • et al.
        Effects of postural and visual stressors on myofascial trigger point development and motor unit rotation during computer work.
        J Electromyogr Kinesiol. 2011; 21: 41-48
        • Bhatnager V.
        • Drury C.G.
        • Schiro S.G.
        Posture, postural discomfort, and performance.
        Hum Factors. 1985; 27: 189-199
        • Rota E.
        • Evangelista A.
        • Ciccone G.
        • et al.
        Effectiveness of an educational and physical program in reducing accompanying symptoms in subjects with head and neck pain: a workplace controlled trial.
        J Headache Pain. 2011; 12: 339-345
        • Komiyama O.
        • Kawara M.
        • Arai M.
        • et al.
        Posture correction as part of behavioural therapy in treatment of myofascial pain with limited opening.
        J Oral Rehabil. 1999; 26: 428-435
        • McNulty W.H.
        • Gevirtz R.N.
        • Hubbard D.R.
        • et al.
        Needle electromyographic evaluation of trigger point response to a psychological stressor.
        Psychophysiology. 1994; 31: 313-316
        • Crockett D.J.
        • Foreman M.E.
        • Alden L.
        • et al.
        A comparison of treatment modes in the management of myofascial pain dysfunction syndrome.
        Biofeedback Self Regul. 1986; 11: 279-291
        • Turner J.A.
        • Mancl L.
        • Aaron L.A.
        Short- and long-term efficacy of brief cognitive-behavioral therapy for patients with chronic temporomandibular disorder pain: a randomized, controlled trial.
        Pain. 2006; 121: 181-194
        • Ferraccioli G.
        • Ghirelli L.
        • Scita F.
        • et al.
        EMG-biofeedback training in fibromyalgia syndrome.
        J Rheumatol. 1987; 14: 820-825
        • Grossman P.
        • Tiefenthaler-Gilmer U.
        • Raysz A.
        • et al.
        Mindfulness training as an intervention for fibromyalgia: evidence of postintervention and 3-year follow-up benefits in well-being.
        Psychother Psychosom. 2007; 76: 226-233
        • Kaplan K.H.
        • Goldenberg D.L.
        • Galvin-Nadeau M.
        The impact of a meditation-based stress reduction program on fibromyalgia.
        Gen Hosp Psychiatry. 1993; 15: 284-289
        • Furlan A.D.
        • van Tulder M.
        • Cherkin D.
        • et al.
        Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the Cochrane Collaboration.
        Spine (Phila Pa 1976). 2005; 30: 944-963
        • Peloso P.
        • Gross A.
        • Haines T.
        • et al.
        Medicinal and injection therapies for mechanical neck disorders.
        Cochrane Database Syst Rev. 2007; (CD000319)
        • Birch S.
        • Jamison R.N.
        Controlled trial of Japanese acupuncture for chronic myofascial neck pain: assessment of specific and nonspecific effects of treatment.
        Clin J Pain. 1998; 14: 248-255
        • Irnich D.
        • Behrens N.
        • Molzen H.
        • et al.
        Randomised trial of acupuncture compared with conventional massage and “sham” laser acupuncture for treatment of chronic neck pain.
        BMJ. 2001; 322: 1574-1578
        • Ga H.
        • Choi J.H.
        • Park C.H.
        • et al.
        Acupuncture needling versus lidocaine injection of trigger points in myofascial pain syndrome in elderly patients–a randomised trial.
        Acupunct Med. 2007; 25: 130-136
        • Zhang J.F.
        • Wu Y.C.
        • Mi Y.Q.
        Observation on therapeutic effect of acupuncture at pain points for treatment of myofascial pain syndrome.
        Zhongguo Zhen Jiu. 2009; 29: 717-720
        • Melzack R.
        • Stillwell D.M.
        • Fox E.J.
        Trigger points and acupuncture points for pain: correlations and implications.
        Pain. 1977; 3: 3-23
        • Trampas A.
        • Kitsios A.
        • Sykaras E.
        • et al.
        Clinical massage and modified proprioceptive neuromuscular facilitation stretching in males with latent myofascial trigger points.
        Phys Ther Sport. 2010; 11: 91-98
        • Gam A.N.
        • Warming S.
        • Larsen L.H.
        • et al.
        Treatment of myofascial trigger-points with ultrasound combined with massage and exercise–a randomised controlled trial.
        Pain. 1998; 77: 73-79
        • Ardic F.
        • Sarhus M.
        • Topuz O.
        Comparison of two different techniques of electrotherapy on myofascial pain.
        J Back Musculoskelet Rehabil. 2002; 16: 11-16
        • Graff-Radford S.B.
        • Reeves J.L.
        • Baker R.L.
        • et al.
        Effects of transcutaneous electrical nerve stimulation on myofascial pain and trigger point sensitivity.
        Pain. 1989; 37: 1-5
        • Smania N.
        • Corato E.
        • Fiaschi A.
        • et al.
        Repetitive magnetic stimulation: a novel therapeutic approach for myofascial pain syndrome.
        J Neurol. 2005; 252: 307-314
        • Farina S.
        • Casarotto M.
        • Benelle M.
        • et al.
        A randomized controlled study on the effect of two different treatments (FREMS AND TENS) in myofascial pain syndrome.
        Eura Medicophys. 2004; 40: 293-301
        • Chu J.
        • Schwartz I.
        eToims twitch relief method in chronic refractory myofascial pain (CRMP).
        Electromyogr Clin Neurophysiol. 2008; 48: 311-320
        • Chu J.
        • Takehara I.
        • Li T.C.
        • et al.
        Electrical twitch obtaining intramuscular stimulation (ETOIMS) for myofascial pain syndrome in a football player.
        Br J Sports Med. 2004; 38: E25
        • Chu J.
        • Yuen K.F.
        • Wang B.H.
        • et al.
        Electrical twitch-obtaining intramuscular stimulation in lower back pain: a pilot study.
        Am J Phys Med Rehabil. 2004; 83: 104-111
        • Majlesi J.
        • Unalan H.
        High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: a randomized, double-blind, case-control study.
        Arch Phys Med Rehabil. 2004; 85: 833-836
        • Srbely J.Z.
        • Dickey J.P.
        Randomized controlled study of the antinociceptive effect of ultrasound on trigger point sensitivity: novel applications in myofascial therapy?.
        Clin Rehabil. 2007; 21: 411-417
        • Ay S.
        • Evcik D.
        • Tur B.S.
        Comparison of injection methods in myofascial pain syndrome: a randomized controlled trial.
        Clin Rheumatol. 2010; 29: 19-23
        • Draper D.O.
        • Mahaffey C.
        • Kaiser D.
        • et al.
        Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles.
        Physiother Theory Pract. 2010; 26: 167-172
        • Shin S.M.
        • Choi J.K.
        Effect of indomethacin phonophoresis on the relief of temporomandibular joint pain.
        Cranio. 1997; 15: 345-348
        • Graff-Radford S.B.
        • Reeves J.L.
        • Jaeger B.
        Management of chronic head and neck pain: effectiveness of altering factors perpetuating myofascial pain.
        Headache. 1987; 27: 186-190
        • Edwards J.
        • Knowles N.
        Superficial dry needling and active stretching in the treatment of myofascial pain–a randomised controlled trial.
        Acupunct Med. 2003; 21: 80-86
        • Hong C.Z.
        Considerations and recommendations regarding myofascial trigger point injection.
        J Muscoskel Pain. 1994; 2: 29-54
        • Kalichman L.
        • Vulfsons S.
        Dry needling in the management of musculoskeletal pain.
        J Am Board Fam Med. 2010; 23: 640-646
        • Tsai C.T.
        • Hsieh L.F.
        • Kuan T.S.
        • et al.
        Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle.
        Am J Phys Med Rehabil. 2010; 89: 133-140
        • Tekin L.
        • Akarsu S.
        • Durmus O.
        • et al.
        The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial.
        Clin Rheumatol. 2013; 32: 309-315
        • Kietrys D.M.
        • Palombaro K.M.
        • Azzaretto E.
        • et al.
        Effectiveness of dry needling for upper quarter myofascial pain: a systematic review and meta-analysis.
        J Orthop Sports Phys Ther. 2013; 43: 620-634
        • Baldry P.
        • Yunus M.
        • Inanici F.
        Myofascial pain and fibromyalgia syndrome: a clinical guide to diagnosis and management.
        Churchill Livingstone, Edinburgh (United Kingdom)2001
        • Ceccherelli F.
        • Rigoni M.T.
        • Gagliardi G.
        • et al.
        Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study.
        Clin J Pain. 2002; 18: 149-153
        • Lennard T.
        Trigger point injections.
        in: Lennard T. Pain procedures in clinical practice. Elsevier, Philadelphia2011: 89
        • Iwama H.
        • Akama Y.
        The superiority of water-diluted 0.25% to neat 1% lidocaine for trigger-point injections in myofascial pain syndrome: a prospective, randomized, double-blinded trial.
        Anesth Analg. 2000; 91: 408-409
        • Iwama H.
        • Ohmori S.
        • Kaneko T.
        • et al.
        Water-diluted local anesthetic for trigger-point injection in chronic myofascial pain syndrome: evaluation of types of local anesthetic and concentrations in water.
        Reg Anesth Pain Med. 2001; 26: 333-336
        • Venancio Rde A.
        • Alencar F.G.
        • Zamperini C.
        Different substances and dry-needling injections in patients with myofascial pain and headaches.
        Cranio. 2008; 26: 96-103
        • Cummings T.M.
        • White A.R.
        Needling therapies in the management of myofascial trigger point pain: a systematic review.
        Arch Phys Med Rehabil. 2001; 82: 986-992
        • Hong C.Z.
        Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response.
        Am J Phys Med Rehabil. 1994; 73: 256-263
        • Gerwin R.D.
        • Shannon S.
        • Hong C.Z.
        • et al.
        Interrater reliability in myofascial trigger point examination.
        Pain. 1997; 69: 65-73
        • Casale R.
        • Tugnoli V.
        Botulinum toxin for pain.
        Drugs R D. 2008; 9: 11-27
        • Aoki K.R.
        Review of a proposed mechanism for the antinociceptive action of botulinum toxin type A.
        Neurotoxicology. 2005; 26: 785-793
        • Gobel H.
        • Heinze A.
        • Heinze-Kuhn K.
        • et al.
        Botulinum toxin A for the treatment of headache disorders and pericranial pain syndromes.
        Nervenarzt. 2001; 72: 261-274
        • Soares A.
        • Andriolo R.B.
        • Atallah A.N.
        • et al.
        Botulinum toxin for myofascial pain syndromes in adults.
        Cochrane Database Syst Rev. 2012; (CD007533)
        • Ferrante F.M.
        • Bearn L.
        • Rothrock R.
        • et al.
        Evidence against trigger point injection technique for the treatment of cervicothoracic myofascial pain with botulinum toxin type A.
        Anesthesiology. 2005; 103: 377-383
        • Wheeler A.H.
        • Goolkasian P.
        • Gretz S.S.
        A randomized, double-blind, prospective pilot study of botulinum toxin injection for refractory, unilateral, cervicothoracic, paraspinal, myofascial pain syndrome.
        Spine (Phila Pa 1976). 1998; 23 ([discussion: 1667]): 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
        • Fishman L.M.
        • Konnoth C.
        • Rozner B.
        Botulinum neurotoxin type B and physical therapy in the treatment of piriformis syndrome: a dose-finding study.
        Am J Phys Med Rehabil. 2004; 83 ([quiz: 51–3]): 42-50
        • Lang A.M.
        Botulinum toxin type B in piriformis syndrome.
        Am J Phys Med Rehabil. 2004; 83: 198-202
        • Fishman L.M.
        • Anderson C.
        • Rosner B.
        BOTOX and physical therapy in the treatment of piriformis syndrome.
        Am J Phys Med Rehabil. 2002; 81: 936-942
        • Qerama E.
        • Fuglsang-Frederiksen A.
        • Kasch H.
        • et al.
        A double-blind, controlled study of botulinum toxin A in chronic myofascial pain.
        Neurology. 2006; 67: 241-245
        • Gobel H.
        • Heinze A.
        • Reichel G.
        • et al.
        Efficacy and safety of a single botulinum type A toxin complex treatment (Dysport) for the relief of upper back myofascial pain syndrome: results from a randomized double-blind placebo-controlled multicentre study.
        Pain. 2006; 125: 82-88
        • Kamanli A.
        • Kaya A.
        • Ardicoglu O.
        • et al.
        Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome.
        Rheumatol Int. 2005; 25: 604-611
        • Gerwin R.
        Botulinum toxin treatment of myofascial pain: a critical review of the literature.
        Curr Pain Headache Rep. 2012; 16: 413-422