Botulinum toxin application in erector spinae blockade for the management of myofascial syndrome in patients with fibromyalgia: A case series

Botulinum toxin (BoNT) is a type of bacterial exotoxin that has been included in medical practice for multiple purposes, one of which is pain management. Some of the proposed mechanisms state that BoNT can reduce neurogenic inflammation by blocking the discharge of neuropeptides, including substance P and calcitonin gene-related peptides. Here, we present three patients with myofascial syndrome and fibromyalgia whose main symptom was pain in the dorsal region, wherein BoNT administered in the erector spinae bilaterally provided prolonged pain relief.