Use of botulinum neurotoxin in the treatment of low-back pain

doi:10.1017/CBO9781139178068.030

Chapter 29 - Use of botulinum neurotoxin in the treatment of low-back pain

Published online by Cambridge University Press: 05 February 2014

José De Andrés and

Edited by

Mark Hallett and

José De Andrés: Affiliation:
Department of Surgical Specialties, Valencia School of Medicine and Anesthesia Department of Anesthesiology, Critical Care and Pain Management, Valencia University General Hospital, Valencia, Spain
Gustavo Fabregat: Affiliation:
Department of Surgical Specialties, Valencia School of Medicine and Department of Anesthesiology, Critical Care and Pain Management, Valencia University General Hospital,Valencia, Spain
Daniel Truong: Affiliation:
The Parkinson’s and Movement Disorders Institute, Fountain Valley, California
Dirk Dressler: Affiliation:
Department of Neurology, Hannover University Medical School
Mark Hallett: Affiliation:
George Washington University School of Medicine and Health Sciences, Washington, DC
Christopher Zachary: Affiliation:
Department of Dermatology, University of California, Irvine

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Summary

Introduction

Chronic low-back pain is one of the leading causes of physician office visits and work absenteeism in developed countries. It is estimated that from 49% to 70% of the adult population will suffer at least one episode of low-back pain over their lifetime (Koes et al., 2006).

Although the etiopathogenesis of non-specific low-back pain is unknown, multiple factors may be involved in pain occurrence. Involvement of the muscles directly or indirectly stabilizing the lumbar spine may play a significant role in the occurrence and maintenance of low-back pain syndromes (Porterfield and DeRosa, 1998).

This chapter reviews the pathophysiology, diagnosis and treatment with botulinum neurotoxin (BoNT) of myofascial pain of muscles involved in lumbosciatic conditions (quadratus lumborum, iliopsoas and paravertebral) (Table 29.1). The piriformis muscle is reviewed in the next chapter.

Quadratus lumborum muscle

Dysfunction of the quadratus lumborum muscle is considered the most common cause of low-back pain by many authors (Travell and Simmons, 1983). Its impairment may be severely disabling as it plays an important stabilizing role in the spine, and makes the load of standing body weight intolerable.

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Type: Chapter
Information: Manual of Botulinum Toxin Therapy , pp. 247 - 258

DOI: https://doi.org/10.1017/CBO9781139178068.030 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2014

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References

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