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Chapter 34 - Use of Botulinum Toxin in the Treatment of Low Back Pain
- By José De Andrés, Gustavo Fabregat, Ruben Rubio-Haro, Carmen De Andrés-Serrano
Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
Book:

Manual of Botulinum Toxin Therapy

Published online:

02 November 2023

Print publication:

23 November 2023, pp 275-289
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Summary

Chronic low back pain (CLPB) is one of the leading causes of physician office visits and work absenteeism in developed countries. Because many of the muscle groups involved in CLBP are easily accessible and respond well to injection, this disorder may be seen as particularly amenable to treatment with botulinum neurotoxin (BoNT). This chapter reviews the pathophysiology, diagnosis and treatment with BoNT of myofascial pain of muscles involved in lumbosciatic conditions (quadratus lumborum, iliopsoas and paravertebral). Physical examination of the patient is discussed and illustrated. Anatomy is reviewed, and anatomical diagrams are provided, along with discussion of guidance techniques, such as fluoroscopy, for the accurate placement and dosing of injections.