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Chapter 34 - Use of Botulinum Toxin in the Treatment of Low Back Pain

Published online by Cambridge University Press:  02 November 2023

By
José De Andrés ,
Gustavo Fabregat ,
Ruben Rubio-Haro  and
Carmen De Andrés-Serrano
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Chronic low back pain (CLPB) is one of the leading causes of physician office visits and work absenteeism in developed countries. Because many of the muscle groups involved in CLBP are easily accessible and respond well to injection, this disorder may be seen as particularly amenable to treatment with botulinum neurotoxin (BoNT). This chapter reviews the pathophysiology, diagnosis and treatment with BoNT of myofascial pain of muscles involved in lumbosciatic conditions (quadratus lumborum, iliopsoas and paravertebral). Physical examination of the patient is discussed and illustrated. Anatomy is reviewed, and anatomical diagrams are provided, along with discussion of guidance techniques, such as fluoroscopy, for the accurate placement and dosing of injections.

Keywords

Chronic low back painCLPBbotulinum toxinBoNTmyofascial painquadratus lumborumiliopsoastrigger points
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 275 - 289
Publisher: Cambridge University Press
Print publication year: 2023

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References

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