Botox® was first approved by the FDA for cosmetic use in 2002 and since then, has become synonymous with facial wrinkle reduction and creating, at least temporarily, a more youthful look. Today, however, physicians are also successfully using Botox® to treat serious medical conditions, including muscle spasticity resulting from brain and spinal cord injury, chronic migraine and other neurological disorders.
Botox® is one of four products on the market (including Myobloc®, Xeomin® and Dysport®) that have been approved to treat specific neurological conditions, in addition to being used to treat facial wrinkles. Botox® has been on the market for the longest period of time in the U.S., and has been approved to treat the greatest number of disorders.
Bradley Benson, D.O., a physician with YRMC PhysicianCare specializing in physical medicine and rehabilitation, frequently uses Botox® therapy to treat patients with spastic muscles resulting from stroke, cerebral palsy, and traumatic brain or spinal cord injury. Dr. Benson states, “Chronic muscle spasm can develop many weeks after a traumatic injury or stroke. Muscles in different parts of the body become frozen and locked into place, causing pain and reduced mobility. Botox® injections, precisely guided into the affected muscles, produce relief within one to two weeks. Treatments can be repeated once every three to four months and are usually combined with other therapies, like physical and occupational therapy. Pain and other medications can often be reduced as a result of this treatment.”
Dr. Benson emphasizes that the earlier the treatment begins the better. If muscles are tight and locked into place for too long, other connective tissues also become tight and inflexible and may require corrective surgery.
Chronic migraine, diagnosed when a patient experiences 15 or more headaches a month, including at least 8 migraines, is another condition that may be treated with Botox® injections. Dr. Benson explains, “Many migraines result from stress-induced muscle tension in the head, forehead and neck. Precise injections into each of these muscles can result in a 75-80% improvement after two treatments”.
Other forms of involuntary muscle spasm may also benefit from treatment with Botox® and related products. These include sudden urinary incontinence, cervical dystonia (misalignment of the head and neck) and hemifacial spasm, the sudden contraction of facial muscles.
Botulinum toxin (BT), produced by the bacterium Clostridium botulinum, is the active ingredient responsible for the therapeutic effects of Botox® and related products. BT is a potent neurotoxin (producing muscle paralysis), but when used in a precise, controlled manner, can be used safely and effectively.
However, side effects do occur. In 2009, the FDA issued an order requiring a black box warning on all BT products. This warning is in response to reports of the effects of injections spreading to areas beyond the injection site, causing difficulty breathing, swallowing or speaking; muscle weakness; loss of bladder control; drooping eyelids; and blurred vision. As with any new drug or treatment, patients should thoroughly discuss the potential benefits and side effects of BT therapy with a qualified physician.
For more information about Botox, contact YRMC PhysicianCare’s Spine Center at (928) 445-4818.