IADR Abstract Archives
Botulinum Toxin Treatment for Refractory Masticatory Myofascial Pain: Randomized Double-Blind Study.
Objectives: To evaluate the efficacy of BoNT-A over placebo on pain intensity and somatosensory and psychosocial features
Methods: Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of >50 mm on the visual analogue scale (VAS) participated. Patients were randomly assigned to receive a total of 80 U of BoNT-A or saline solution (SS) injected into the masseter and anterior temporalis muscles. Pain intensity (VAS), quantitative sensory testing (QST), conditioned pain modulation (CPM), and psychosocial status were examined. Follow-up was performed at 1 and 6 months. For repeated-measure comparisons between evaluation times, Friedman test with Bonferroni correction was used for pain and somatosensory variables and the Wilcoxon test for the psychosocial variables. The Mann-Whitney test was used for all comparisons between groups.
Results: The BoNT-A group presented a significant decrease in pain intensity at follow-ups compared with the SS group (p<0.001). Higher PPT values in the masseter muscle for BoNT-A group compared to SS (p<0.03) at all follow-ups were also found. No differences were found for mechanical pain threshold and wind-up ratio values (p>0.05) in the entire study. BoNT-A group presented the most efficient CPM effect (p<0.03) at the 1-month follow-up. Also, BoNT-A presented a significant improvement in all psychosocial variables (p<0.05), however significant groups differrences were found just for the Central Sensitization Inventory (p<0.01), Pittsburgh Sleep Quality Index (p<0.004), and Healthy Survey 36 (p<0.05) at 6-month follow-up.
Conclusions: A single injection-session of BoNT-A has positive effects on the hall pain spectrum of patients with refractory masticatory myofascial pain.
Methods: Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of >50 mm on the visual analogue scale (VAS) participated. Patients were randomly assigned to receive a total of 80 U of BoNT-A or saline solution (SS) injected into the masseter and anterior temporalis muscles. Pain intensity (VAS), quantitative sensory testing (QST), conditioned pain modulation (CPM), and psychosocial status were examined. Follow-up was performed at 1 and 6 months. For repeated-measure comparisons between evaluation times, Friedman test with Bonferroni correction was used for pain and somatosensory variables and the Wilcoxon test for the psychosocial variables. The Mann-Whitney test was used for all comparisons between groups.
Results: The BoNT-A group presented a significant decrease in pain intensity at follow-ups compared with the SS group (p<0.001). Higher PPT values in the masseter muscle for BoNT-A group compared to SS (p<0.03) at all follow-ups were also found. No differences were found for mechanical pain threshold and wind-up ratio values (p>0.05) in the entire study. BoNT-A group presented the most efficient CPM effect (p<0.03) at the 1-month follow-up. Also, BoNT-A presented a significant improvement in all psychosocial variables (p<0.05), however significant groups differrences were found just for the Central Sensitization Inventory (p<0.01), Pittsburgh Sleep Quality Index (p<0.004), and Healthy Survey 36 (p<0.05) at 6-month follow-up.
Conclusions: A single injection-session of BoNT-A has positive effects on the hall pain spectrum of patients with refractory masticatory myofascial pain.