Some kinds of pain may be helped with injections of a neurotoxin commonly used in cosmetics - that which is produced by strains of the Clostridium botulinum bacteria. This substance is well known for its therapeutic effects when injected into muscle tissue. It was originally used to treat muscle control disorders, such as spasticity and dystonia, and is now also used to treat certain types of pain. Some examples are as follows:
Injections work to treat muscle pain by stopping nerve endings within the muscle from releasing the muscle-stimulating neurotransmitter known as acetylcholine. The result is a reduction in muscular tone (i.e. tightness and rigidity) and overactivity, which basically allows the muscle to relax. It is especially effective in painful conditions that are due to muscular spasms, contraction or overactivity – for example, myofascial trigger points and some cases of myofascial pain syndrome.
Low Back Pain:
Patients with chronic low back pain of muscular origin, especially due to overactivity or stretch of the deep paravertebral muscles (the muscles that run along the back of the spine), may benefit from these injections.
Migraine & Headache:
Injections may be effective in relieving or preventing migraine, chronic headaches, tension headaches and other headache syndromes. It is injected into various muscles of the head/face and/or neck. One way in which it is thought to work is by reducing sensory activity in the facial muscles.
Recent studies have shown that such injections may have pain-relieving effects that aren’t related to the muscle relaxation effects and may be helpful in reducing inflammatory pain and neuropathic (nerve) pain. Examples include postherpetic neuralgia (nerve pain after shingles), trigeminal neuralgia (facial pain arising from the trigeminal nerve), diabetic neuropathy (nerve pain secondary to diabetes), complex regional pain syndrome (CRPS), spinal cord injury pain and post-stroke pain. How it works to treat these forms of pain is most likely due to its ability to stop nerve endings from releasing various pain mediators, as well as reducing inflammation around nerve endings, therefore preventing nerve overactivity and interrupting pain signalling within the peripheral and central nervous systems.
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