Comparative analysis of different dilution methods in botulinum toxin application

Myofascial pain syndrome is a chronic condition causing muscle pain and trigger points, which can greatly affect a person's quality of life. Botulinum toxin type A may be an effective treatment for myofascial pain syndrome, providing long-lasting pain relief. However, the pain from injections can impact patient comfort and their willingness to continue treatment. This study was performed to compare pain levels in patients receiving BTX-A diluted with either lidocaine or saline. The study involved 90 patients with chronic myofascial pain syndrome. Thirty-seven received BTX-A diluted with 2% lidocaine without epinephrine, while 53 received BTX-A diluted with saline. Pain was measured using a visual analogue scale (VAS 0-10) at three time points: before, during, and 1 month after the injections. Patients in the lidocaine group experienced significantly more pain during the injections than those in the saline group (mean VAS score 4.59 vs 3.15; P = 0.002). Nevertheless, both groups showed a significant reduction in pain over time, from pre-injection to post-injection (lidocaine group, P < 0.001; saline group, P < 0.001), indicating effective long-term pain relief for both treatments. BTX-A was demonstrated to be an effective and safe treatment for myofascial pain syndrome, regardless of the dilution solution used.