Inclusion Criteria:

• Outpatient, male and female subjects, of any race, between 18 years of age and older. Female subjects of childbearing potential must have a negative urine pregnancy test result at the Screening/Baseline Visit. (A female is considered of childbearing potential unless she is postmenopausal or without a uterus and/or both ovaries.)
• Subjects suffering from cervicothoracic muscle pain with or without cervical dystonia. The pain must be of at least 3 months duration and characterized by a numerical pain rating score of at least 5 on the pain subscale of the TWSTR scale.
• Subjects who are able to understand the requirements of the study and sign an Informed Consent Form.

Exclusion Criteria:

• Female subjects who are pregnant (positive urine pregnancy test) or who have an infant they are breast-feeding or who are of childbearing potential and not practicing a reliable method of birth control (OCP or barrier).
• Subjects who have had standard trigger point injections with local anesthetics in the last 3 months.
• Subjects who have had chiropractic manipulation of the neck or upper thoracic region in the last 3 months or plan on having such manipulations during the study.
• Subjects, who by clinical evaluation and / or MRI study, are considered to have symptomatic cervical and/or thoracic disc pathology as primary etiology of their pain.
• Subjects whose cervical spine ROM is restricted in the setting of arthritic conditions (advanced osteoporosis, degenerative arthritis, ankylosing spondylitis).
• Significant medical or psychiatric comorbid disease, as deemed by the investigators
• Litigation involving the existence or cause for neck pain and/or headache
• Pending disability assessment
• Subjects with a diagnosis of Myasthenia Gravis, Eaton-Lambert Syndrome, Amyotrophic Lateral Sclerosis or any other disease that might interfere with neuromuscular function.
• Subjects currently using aminoglycoside antibiotics or agents that interfere with neuromuscular function.
• Subjects with profound atrophy or excessive weakness of the muscles in the target area(s) of injection.
• Subjects with an infection at the injection site or systemic infection (in this case, postpone study entry until one week following recovery).
• Subjects with an allergy or sensitivity to any component of the test medication.
• Subjects with a history of poor cooperation, non-compliance with medical treatment, or unreliability.
• Subjects currently participating in an investigational drug study or who have participated in an investigational drug study within 30 days of the Baseline Visit.