In this review, the author used PubMed to search the literature for studies involvling the use of botulinum toxin for treating myofascial (muscle) pain. Included in the review were open-label studies, single-blinded and double-blinded studies, randomized and controlled, or not.
Based on his findings, the author concluded that there is insufficient evidence at the current time to guide clinical practice. Because he included such diverse types of studies, many of which were not blinded or controlled, it should be expected that the review would not provide a definitive answer.
However, even if it had shown a positive result, there are other reasons to question the use of botulinum toxin for this purpose. First, it does not address the cause of the problem but rather attempts to treat the symptoms. Second, it provides only temporary relief in most instances and, therefore, needs to be repeated. Finally, its use is not without possible complications, including disfiguring muscle atrophy when repeated multiple times.
Our thanks to Dr. Daniel Laskin for providing us with the summary of this study by R. Gerwin, which was published in Current Pain and Headache Reports, 7/18/12. Dr. Daniel Laskin is the TMJA's Clinical Consultant and Professor and Chairman Emeritus at the Virginia Commonwealth University, Department of Oral and Maxillofacial Surgery in Richmond, VA.