Botox relieved woman's postop myofascial pain. (After Radical Mastectomy).

SAN DIEGO -- Botulinum toxin, widely touted for its cosmetic benefits, relieved myofascial pain due to reconstructive surgery following radical mastectomy in a 50-year-old woman.

The woman visited the Brighton PainCare clinic in Portland, Maine, complaining of persistent pain in her pectoral and shoulder regions after she received a latissimus dorsi flap following a right-sided radical mastectomy. Right shoulder abduction was limited to 150 degrees before signs of impingement emerged. Pain was also present in the left and right paraspinal regions. Her pain intensity, as measured on a visual analog score, was 8 on a scale of 0 to 10, Dr. John Pier reported in a poster presentation at the 10th World Congress on Pain.

On physical examination she had significant contraction in the latissimus dorsi flap and tenderness in the rhomboid, superior trapezius, supraspinatus, and along the right sternal border. Treatment with amitriptyline, tramadol, and tizanidine had proven unsuccessful, as had physical therapy and use of trigger-point injections.

The patient underwent injections of 100 U of botulinum toxin each in the ...