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

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.