Intramuscular botulinum toxin-A in complex regional pain syndrome resistant to standard treatment: a case report

Summary Objective To present a patient with complex regional pain syndrome type 1 (CRPS-I) and improvement of contracture of hand muscles and grip strength after successful treatment with botulinum neurotoxin‑A (BoNT-A). Case A 53-year-old woman with CRPS‑I experienced severe allodynia, swelling and autonomic changes in the left hand after a distal radius fracture. Over the succeeding months, she developed contracture of the left hand muscles which was treated with injection of BoNT‑A into the hand muscles (10 points). Results In the patient treatment with BoNT‑A an improvement was seen in the hand range of motion (ROM) and grip strength. Conclusion Successful results can be obtained with BoNT‑A injection in treatment-resistant CRPS‑I cases which may develop joint contracture.