Work

Pain drawings in evaluating treatment benefit of botulin toxin in masticatory muscle pain

Year: 2025

Type: article

Abstract: OBJECTIVES: Studies on the use of botulinum toxin A (BoNT-A) in TMD-related myalgia suggest that some patients benefit from the injections. The aim of this study was to assess which patient group, regarding pain sites and self-reported comorbid pains, benefits most from the injections. MATERIALS AND METHODS: 66 patients were enrolled in a randomized, double-blind, cross-over study. In the first period, patients in group 1 (n = 33) were injected with 50 U of BoNT-A, and patients in group 2 (n = 33) with saline solution. The cross-over was at 16 weeks. A final cohort of 54 patients with full follow-up data was included in the statistical analyses. Patients were pooled and divided into three groups depending on the extent of the pain areas based on their pain drawings (PD): regional (RP), local (LP) widespread (WP) pain groups. Treatment response assessment was performed using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) tools. RESULTS: In the short term (2 weeks), a clear reduction in pain areas was observed in the LP (84.2 %) and RP groups (80.9 %), but not in the WP group (64.3 %). In the long term (16 weeks), the reduction in pain areas was most evident in the RP group (71.4 %), with significant pain reduction in the shoulder and back areas (p < 0.05). The reduction of pain intensity and pain-related disability was least evident in the WP group. CONCLUSION: BoNT-A injections might be considered for treatment in patients with localized and regional pain, however other treatment modalities should be considered in patients with widespread pain. Pain drawing could be a useful screening tool for treatment planning.

Source: Toxicon

DOI: 10.1016/j.toxicon.2025.108455

Authors: Alina Valli, Victoria Sitnikova, Pentti Kemppainen, Leena Kämppi, Leena Kämppi, Antti Kämppi

Institutions: University of Helsinki, Helsinki University Hospital, Hospital District of Helsinki and Uusimaa

Language: English

Topic: Temporomandibular Joint Disorders

Subfield: Complementary and Manual Therapy

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,340