A reader questioned the idea of whether botox would work for Fibromyalgia, since it works well for migraines, and has also helped her TMJ. So, I decided to do a little digging in the medical literature and see if I could find anything to back up the idea of Botox for Fibromyalgia. There are multiple types of trigger point therapy used for Fibromyalgia, including saline injections, steriod injections, and botox injections, among others.
In a review of previous studies on the use of Botox for myofascial pain (Desai, Shkolnikova, Nava, & Inwald, 2014) only one out of five studies examined showed positive effects. Unfortunately, it was also one that was focused primarily on headaches and neck pain rather than on pain in other areas of the body. It was also a relatively small study (but they all were) with only about 15 people. The size of these studies may impact the results.
The second review (Scott, Guo, Barton, & Gerwin, 2009) compared 15 studies involving multiple types of trigger point therapies, including botox, lidacaine, saline, etc. This review found that botox was no more or less effective than lidacaine or saline. One issue that was brought up in the first review that I read was that Botox was being compared to saline rather than a true control or placebo. Since saline is known to have some effect on muscle pain, it’s hard to know how well Botox actually works. Another issue is the small sample size in ALL of the studies, perhaps too small to get an accurate measure.
Overall, there hasn’t been enough study into how well Botox injections work for myofascial pain beyond the head, so this is an area that needs more study. A few doctors are offering this as an option, and if you’ve had it I’d love to know your experience with it. Where did you have the injections (what part of your body)? Did it help your pain? How much? And, for how long?
- Connection Between TMJ Disorder and Fibromyalgia
- Vagus Nerve Stimulation for Migraine & Cluster Headache
- Intravenous Meds for Chronic Pain
- Epidural Injections for Chronic Back Pain
Desai, M. J., Shkolnikova, T., Nava, A., & Inwald, D. (2014). Review Articles: A Critical Appraisal of the Evidence for Totulinum Toxin type A in the Treatment for Cervico-Thoracic Myofascial Pain Syndrome. Pain Practice, 14185-195. doi:10.1111/papr.12074
Scott, N., Guo, B., Barton, P. M., & Gerwin, R. D. (2009). Trigger Point Injections for Chronic Non-Malignant Musculoskeletal Pain: A Systematic Review. Pain Medicine, 10(1), 54-69. doi:10.1111/j.1526-4637.2008.00526.x
Debbi Ward says
Hey, I was diagnosed with arthritic tmj and fibro thirty-three years ago.
My rheumatologist started me on several drugs, massage therapy and traction with the physical therapist. He also did trigger point injections in the occipital region and upper traps.
The drugs changed over the years and the trigger point injections only gave relief for about 24 hrs, then the spasms began again.
After about sixteen years, my pain worstened and spread down the center of the back and around the shoulder blades. So, he sent me to a neurologist that was doing a study using Botox.
It’s been sixteen years and I swear by the injections. However, not every pain spot can be injected, so you do have problem spots but a 2% lidocaine injection lessons the problem.
My biggest problem now is that Medicare just decided not to cover muscle spasms as a diagnosis for Botox injections, which means I have to lay out $1500 for 200mg of Botox and the office visit.
I hope this helps others to decide on the injections but please make sure your specialist is a Board Certified pain specialist, rheumatologist or neurologist for safety.
It seems like insurance is often our worst nemesis when it comes to getting appropriate care. Too often the things that help us most are things that we end up paying out of pocket for – and that’s just expensive and for many of us just not possible. I hate that you are running into this.
I just came across your site and wanted to tell you my botox story, in short. I have had endo, severe headaches and neck pain for years and was recent loosely diagnosed with mild fibro. I had botox injections for the headaches and neck pain 3 times. On the third injection I ended up in the ER unable to properly lift my arms or walk without assistance – among other equally scary side effects. It’s been a year and I am still suffering with extreme weakness leaving me unable to work or accomish basic daily tasks – not from fibro but from the botox. Just the other day, my gp told me that new research suggests that botox is contraindicated for people with fibro as botox affects your neurotransmitters. So, to your readers: please do your reasearch before going this route. For me, the side effects have been worse than my fibro ever was. Take care!
Thank you for sharing this. I’ve not tried botox for anything yet, as I’ve not really wanted to. However, after readers ask me about different treatments I try to find what research is available. I’ll have to look and see if new research is out on this. It’s amazing the things we are willing to go through in hopes of reducing our pain.
now was the endo and migraines due to the fibro? Because I’m having bad gyno issues as well and i read that fibro and endo go hand in hand. Also, I read that headaches are caused from the widespread pain. I too was diagnosed with fibro at a very young age, I was 19. I have been suffering for years, with absolutely no relief that lasts. I’m at the end of my rope. I can;t take it anymore nothing works! I just want to function like a normal 20 years old that’s not in pain! WHY IS THAT SO MUCH TO ASK FOR!?!? With all the technology and innovation that we have you would think that there would be a cure for everything! I hate letting my diagnosis control me but what else can I do when I’m in constant severe pain? Not to mention on all these different medication for being bi-polar and having anxiety and sleeping disorders, which I think is related to the fibro as well. i feel like I;m a mess and falling apart at the seems. I refuse to go on pain meds, that’s not how I want to live my life, but at the same time what choice to do I have if I’m in so much pain?!?! My PCP wants me to go to aquatic therapy and pain management and get injections in my back for the pain, mainly botox. I’ve read though that it’s poison to the body in long run….HELP! where to turn, what to do ?
No Fibro doesn’t cause those things, but they are all commonly linked. It’s not uncommon for someone who has one of those diagnoses to have more of them. Endo has been linked to chronic pain all over the body (which makes you wonder if perhaps the Endo causes the Fibro). The stress of migraines can also cause you to tighten your muscles all over and could lead to pain throughout, as well. The chronic pain can certainly lead to or add to anxiety and depression, so there is definitely an impact there. There is nothing to fear in pain meds, take them if you need them. But, there are other ways to fight back and I would pursue all options. It was when I reached the point that you are at that I finally was willing to question whether diet might actually impact my pain. By starting from scratch and taking my diet down to the very bare essentials I was able to identify several things that definitely have a negative impact on my pain levels. I removed those items and it has helped immensely. I still have pain and I still have bad days but it’s nothing compared to what it was. Do the aquatic therapy, it really is one of the best things. A warm water pool can help so much!