The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache

• Published in: Journal of headache and pain Vol. 17; no. 1; p. 29
• Main Authors: Pihut, Malgorzata, Ferendiuk, Ewa, Szewczyk, Michal, Kasprzyk, Katarzyna, Wieckiewicz, Mieszko
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 24.03.2016; Springer Nature B.V
• Subjects: Adult; Botulinum Toxins, Type A - pharmacology; Botulinum Toxins, Type A - therapeutic use; Female; Headaches; Humans; Injections, Intramuscular; Internal Medicine; Joints; Male; Masseter Muscle - drug effects; Medicine; Medicine & Public Health; Middle Aged; Muscular system; Myalgia - drug therapy; Neurology; Neuromuscular Agents - pharmacology; Neuromuscular Agents - therapeutic use; Pain; Pain Measurement; Pain Medicine; Prospective Studies; Research Article; Temporomandibular Joint Dysfunction Syndrome - drug therapy; Tension-Type Headache - drug therapy; Treatment Outcome; Young Adult; Tension-type headache; Masseter muscle pain; Botulinum toxin; Temporomandibular joint dysfunction
• ISSN: 1129-2369; 1129-2377; 1129-2377
• DOI: 10.1186/s10194-016-0621-1

Background Temporomandibular joint dysfunction are often accompanied by symptoms of headache such as tension-type headache which is the most frequent spontaneous primary headache. Masseter muscle pain is commonly reported in this group. The purpose of the study was to assess the efficiency of intramuscular botulinum toxin type A injections for treating masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. Methods This prospective outcome study consisted of 42 subjects of both genders aged 19–48 years diagnosed with masseter muscle pain related to temporomandibular joint dysfunction and tension-type headache. The subjects were treated by the intramuscular injection of 21 U (mice units) of botulinum toxin type A (Botox, Allergan) in the area of the greatest cross-section surface of both masseter bellies. Pain intensity was evaluated using visual analogue scale (VAS) and verbal numerical rating scale (VNRS) 1 week before the treatment and 24 weeks after the treatment. The obtained data were analyzed using the Wilcoxon matched pairs test ( p ≤ 0,005). Results The results of this study showed a decrease in the number of referred pain episodes including a decrease in pain in the temporal region bilaterally, a reduction of analgesic drugs intake as well as a decrease in reported values of VAS and VNRS after injections ( p  = 0,000). Conclusions The intramuscular botulinum toxin type A injections have been an efficient method of treatment for masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.