Pain Disorders other than Migraine

Following injection into the muscle or skin, botulinum toxin blocks the release of pain transmitters and modulators and lead to reduction of pain perception. Botulinum toxin treatment (with Botox) is now approved by FDA for treatment of chronic migraine (Chap. 4 ). High quality studies have shown efficacy of botulinum toxins in several pain syndromes including local pain in diabetic neuropathy, pain after shingles (post-herpetic neuralgia), pain after trauma to the limb, face pain in trigeminal neuralgia, heal pain in plantar fasciitis, non-surgical low back pain, pain associated with Raynaud syndrome and deep buttock pain in piriformis syndrome. Preliminary studies in several other pain syndrome have also demonstrated encouraging results. At the present time, none of these potential pain indications are FDA approved.