Botox and Pain Management

Besides whisking away your wrinkles, is it possible that an injection of Botox can do away with those painful muscle spasms in your neck? Maybe Botox isn’t just for celebrities anymore! Can it help a person with chronic low back pain or a neck that is constantly in knots? The jury is still out on Botox, as most experts agree that there is a scarcity of completed testing. More research needs to be done but the drug holds out hope for some sufferers of chronic neck pain. Botox was originally approved by the FDA in 1989 for the treatment of severe muscle contractions, known as cervical dystonia.

This was long before it became the new panacea for wrinkled brows and furrowed facial creases – the Baby Boomer’s Delight. Botox is a purified form of botulinum toxin, Type A, that has been used for over 20 years. This derivative of the bacterium, Clostridium botulinum, produces a protein that blocks the release of acetycholine and relaxes muscles. Type A is just one of seven different types of botulinum toxins, each of which has different properties. In the 1960s, the muscle relaxing properties of the botulinum toxin were investigated for use in realigning ‘crossed eyes’. These early studies paved the way for other uses of the toxin.

Today, used in extremely small doses, Botox has helped over 1 million patients worldwide with conditions caused by overactive muscles. Botox is now authorized for the treatment of cervical dystonia, to help decrease the severity of the abnormal head position and associated neck pain. It has also been approved for the treatment of strabismus (crossed eyes) and blepharospasm, the involuntary muscle spasms around the face and eyes. Now, a new study has been released that shows Botox may be an appropriate treatment for the relief of pain, caused by chronically contracted neck muscles. This study was published in the January 2004 issue of the American Journal of Pain Management. Researchers evaluated the effects of a single injection of Botox into the affected neck muscles of 25 patients.

The injection was combined with physical therapy. After 3 months of follow-up, the patients with combined treatment showed a significant improvement. The study showed that pain relief from Botox lasted approximately 3 to 6 months. However, researchers question the results of this study and point out that it did not compare the effectiveness of Botox with physical therapy with results that could be gained by physical therapy alone. Experts speculate that the Botox injection relaxed muscles and maximized the potential for rehabilitation and the repair of damaged tissue. As it strengthening weakened muscles, it relieved pain. Other researchers indicate that treating muscle spasms with a Botox injection has an advantage over oral pain relievers because the injections into the muscle are local. They do not have side effects of sedation, lethargy, fatigue, and dizziness associated with oral pain medications. Botox advocates suggest that more extensive testing is needed to verify the benefits of its use in relieving back and neck pain.