Non-invasive physical treatments of myofascial pain

A Double-Blind, Controlled, Randomized Trial to Evaluate the Efficacy of Botulinum Toxin for the Treatment of Lumbar Myofascial Pain in Humans

“…Administering different treatments to the same patient to eliminate interindividual variability did not allow us to differentiate the effect of BTX or placebo based on the patient's daily life activities and psychologic status. More reliable diagnostic criteria for MPS have been suggested, such as evaluation of muscle tenderness with pressure thresholds rather than detection of a local twitch response, 45 but palpating TrPs remains the most commonly used method for diagnosis of MPS. Furthermore, a trial of anesthetic blocking agents has been advocated before botulinum treatment 46 to confirm painful muscle contractions as the primary source of pain generation.…”