Pain Modulation in Chronic Musculoskeletal Disorders: Botulinum Toxin, a Descriptive Analysis

Botulinum neurotoxin (BoNT), a product of Clostridium botulinum, reversibly inhibits the presynaptic release neurotransmitter acetylcholine at neuromuscular junction. In addition, BoNT blocks transmission other substances involved in pain perception and, together with soft-tissue anti-inflammatory effect, may play role analgesia. When first-line treatment fails, second-line therapies might include BoNT. Studies on chronic and recurrent using different mechanisms offer heterogenous results that must be validated standardized. Plantar fasciitis, severe knee osteoarthritis, painful hip arthroplasty, antalgic muscular contractures, neuropathic myofascial syndromes benefit from administration Research this topic has revealed main musculoskeletal conditions can BoNT, stressing effects, modalities administration, doses, schedule.