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When botulinum toxin is injected near a motor end plate, where a trigger point would develop, this reduces the motor nerves ability to drive a sustained taut band in the muscle

Autotomy that occurs long after injury may appear as pain that occurs below the level of the injury (below-level pain) [64, 65], and the late spontaneous worsening may be the result of complete deafferentation of one or several spinal segments the stimulation of the nerve plexus, or dorsal root injury [66]

However, certain circumstances warrant professional evaluation to ensure safety and exclude underlying pathology

(1996) Use of insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 in the diagnosis of acromegaly and growth hormone deficiency in adults

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