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How is botulinum toxin used to treat pain?

Howard S. Smith
Pain Medicine
Botulinum toxin functions as a therapeutic muscle-relaxing agent when it’s injected into the muscle to help relieve pain. Derived from the bacterium Clostridium botulinum, botulinum toxin works at motor nerve endings (nerves that lead to muscles). Pain relief may be from acetylcholine release inhibition and a blocking action on the parasympathetic nervous system. Botulinum toxin appears to produce prolonged muscle relaxation and can be targeted to the particular muscle group associated with the pain. In some patients with migraine and tension headaches, botulinum toxin injections have led to significantly more headache-free days and a decline in pain intensity. Botulinum toxin is available as two types: botulinum toxin serotype A (Botox) and botulinum toxin serotype B (Myobloc). 

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