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