Botox for Spasticity

Spasms or muscle stiffness and tightness that interfere with voluntary movement can affect those who have brain or spinal cord injuries or conditions like cerebral palsy, multiple sclerosis, or strokes. These painful spasms and jerky or repetitive involuntary movements can significantly impact daily activity. Botox injections – similar to those used in cosmetic procedures – can help relieve spasticity symptoms for some patients.

Baptist Health is nationally recognized for excellence in treating various types of movement disorders stemming from brain and spinal cord dysfunction, including spasticity. We offer a full spectrum of neurological care and the latest approaches to pain relief and spasticity management, including Botox therapy. Best of all, you’ll appreciate locations near you and a personalized focus to meet your needs before, during and after your procedure.

When is Botox Used to Treat Spasticity?

In 2010, the U.S. Food and Drug Administration (FDA) approved the use of Botox – a form of the botulinum neurotoxin – for the treatment of upper limb spasticity, which often affects muscles of the elbow, wrist and fingers. In 2015, the FDA approved it for the treatment of lower limb spasticity, which frequently affects ankle and toe muscles.

Good candidates for Botox treatments typically have spasticity in only a few muscle groups. Initial treatment for spasticity includes rehabilitative stretching and exercise programs. These regimens should be continued during Botox treatments to ensure maximum treatment effectiveness.

Small doses of Botox injected into a muscle block the release of a neurotransmitter chemical known as acetylcholine, which transmits messages from the brain through the nerves to tell a muscle to contract. When acetylcholine is blocked, the muscle relaxes.

The FDA approves the use of Botox to treat upper and lower limb spasticity in adults (age 18 and up). Its safety and effectiveness have not been established in pediatric patients, but research studies are active. 

What Can Botox Treatment Accomplish?

Treatment with Botox often requires several rounds of injections – with each round usually working for a few months. Most people notice the effects of Botox one to two weeks after treatment. Your physician will keep track of your symptoms to make sure the treatment is working. Because there is a limit on how much Botox you can safely receive, it may not be effective if your large muscles are affected or you’re experiencing symptoms in many muscle groups at once.

People treated with Botox for spasticity report:

• A significantly reduced number of involuntary jerky or repetitive movements
• A reduced number of painful muscle spasms
• Less muscle tightness and stiffness
• Less disruption to daily activities and work, making it easier to dress, bathe and eat

What Can I Expect During Botox Treatment?

Botox treatments typically take about 10 minutes. Your physician will use a very small needle to inject tiny amounts of Botox into your affected muscles. People describe the injections as feeling like pinpricks. You will receive several injections into the muscle, as Botox doesn’t travel far from the injection site. If the muscles your physician is trying to reach are small or difficult to access, he or she may send short electrical impulses through the needle to make the muscle contract, or record electrical impulses from the muscle, to ensure targeted treatment. Botox injections will be administered right in your physician’s office and you can go home the same day.

Recovery

Botox treatments are performed in your physician’s office on an outpatient basis. Most people who receive these injections can go home or back to work as soon as the session is complete.

Botox Treatment Possible Risks

The most common complaints after Botox treatment for chronic migraines are:

• Mild injection-site pain
• Temporary muscle soreness
• Temporary weakness in the injected muscle and adjacent muscles

Rarely, people report mild, flu-like symptoms within a week of treatment, but these symptoms are short-lived. Allergic reactions to Botox can occur, but they are very rare. Seek immediate medical attention if you experience:

• Hives
• Shortness of breath
• Swelling of the lower legs

In rare cases, people can develop antibodies against the neurotoxin that keep Botox from working to its full potential. Spacing injections out – with a few months between each treatment – can prevent this.

There has never been a confirmed case in which Botox from an injection spread to other parts of the body. However, because botulinum is a neurotoxin, this is theoretically possible and could be life-threatening.

Seek emergency medical attention if you experience any of the following after receiving the injections:

• All-over muscle weakness or loss of strength
• Double vision or blurred vision
• Drooping eyelids
• Hoarseness, change or loss of voice
• Loss of bladder control
• Trouble speaking, swallowing or breathing