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Der Einsatz von Botulinumtoxin in der Therapie von Muskelschmerzen

  • Schwerpunkt: Muskelschmerz
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Zusammenfassung

Es bestehen ausreichend wissenschaftliche Evidenzen dafür, dass Botulinumtoxin (BTX) bei Schmerzen im Rahmen von muskulären Hyperaktivitätszuständen, wie bei Dystonien und bei Spastizität, therapeutisch wirksam ist. Bei myofaszialen Schmerzen und verwandten Erkrankungen steht der definitive Beleg für eine analgetische Wirkung nach Kriterien der evidenzbasierten Medizin noch aus. Bei Fibromyalgie scheint keine sichere klinische Wirkung vorzuliegen.

Zum jetzigen Zeitpunkt wird der Einsatz von BTX-Injektionen zur Behandlung von Muskelschmerzen im Wesentlichen auf Behandlungen im Rahmen von kontrollierten Studien konzentriert bleiben. Nach Abschluss von breit angelegten multizentrischen plazebokontrollierten Studien kann erwartet werden, dass zukünftig die Bedeutung von BTX in der Schmerztherapie zunehmen wird.

Abstract

The analgesic effects of botulinum toxin (BTX) have been discussed controversially due to substantial placebo effects and flaws in the study designs used. Additionally, pathophysiological concepts of pain and the specific analgesic mechanisms of BTX remain largely unclear. Apart from pain reduction through the well-documented effects of BTX at the neuromuscular endplate, additional analgesic mechanisms, including other synaptic and local effects, have been suggested. Currently, BTX can be recommended for pain treatment in dystonia and spasticity. In myofascial pain syndromes, pain relief by BTX injections has been reported, but definite proof according to evidence-based medicinal criteria is still lacking. In fibromyalgia, there seems to be no analgesic effect. The role of BTX in pain therapy is likely to increase in the future.

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Authors and Affiliations

  1. Klinik für Neurologie und Poliklinik, Universität Rostock

    R. Benecke, D. Dreßler, E. Kunesch & T. Probst

  2. Klinik für Neurologie und Poliklinik, Universität Rostock, Gehlsheimer Straße 20, 18147 , Rostock

    R. Benecke

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  1. R. Benecke
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  2. D. Dreßler
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  3. E. Kunesch
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Benecke, R., Dreßler, D., Kunesch, E. et al. Der Einsatz von Botulinumtoxin in der Therapie von Muskelschmerzen. Schmerz 17, 450–458 (2003). https://doi.org/10.1007/s00482-003-0263-5

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