Botox Injections in Pain Management
What are Botox® Injections?
Botox Injections use botulinum toxin to paralyze the muscle activity temporarily. It is the same toxin that is produced by the microbe that causes a type of food poisoning called botulism. It was originally used to make wrinkles harder to see. The injections can also be used for people with repetitive spasms in the neck, overly sweating, and an overactive bladder. It is also used to prevent chronic migraines for some people.
What is a migraine?
It is a neurological disorder that is characterized by reoccurring episodes of headaches and other associated symptoms like nausea, vomiting, and sensitivity to light that last anywhere from four to 72 hours. It may also include visual, speech, and auditory disturbances that occur in one and three patients.
How can they help with pain?
The botulinum toxin injections get in the way of the chemical signals from the nerves to the muscles which cause them to contract. They are used for patients who experience frequent migraines because they can reduce how frequent they experience them. There is no evidence that it will help other kinds of headaches though but it works great for chronic migraines.
How does it work?
The truth is that it is unknown. It has helped to reduce pain but it is still unsure how it actually does it. One theory is that it inhibits the release of peripheral nociceptive neurotransmitters. It is believed that it effects the central pain processing systems that create the migraine headaches. It involves 31 injections in areas that include the bridge of the nose, the temples, the forehead, the back of the head, and the upper back.
What are the side effects?
There are several side effects of Botox injections include itching, rash, allergic reaction, back and neck pain, muscle stiffness, shortness of breath, difficulty swallowing, nausea, stomach pain, diarrhea, loss of appetite, reactions at the injection site, fever, and cough.
Does it hurt?
They use a very sharp and small needle for the injections so it is not really painful. There may be a quick burning sensation at the site of the injection.
How long is the procedure?
The entire procedure only takes about ten to fifteen minutes if an experienced injector takes care of your procedure.
How long is the recovery time?
You can return back to your normal activities immediately.
When will you see the results?
It may take up to two weeks to see results for the first set of injections. For those patients that fail to see results with the first set of injections, they see positive results when the process was repeated.
How long does it work?
Most people will see results for three months. The FDA approved 5 treatments over a 15 month period. The risks for more frequent use has not been tested and the standard of care is to give a set of injections every three months. Clinical trials suggest that eventually the injections can be discontinued without the chronic migraines coming back.
Frampton, J. E. (2012). OnabotulinumtoxinA (BOTOXsuperscript] ?/superscript] ). Drugs, 72(6), 825-845. doi:http://dx.doi.org/10.2165/11208880-000000000-00000
Mayo Clinic Staff. (2013). Botox injections. Mayo Clinic. Retrieved from http://www.mayoclinic.org/tests-procedures/botox/basics/definition/prc-20009036
Migraine Fact Sheets: Botox for Migraine. The Migraine Trust. Retrieved from http://www.migrainetrust.org/factsheet-botox-for-migraine-10899
Rothrock, J. F. (2012). Botox-A for suppression of chronic migraine: commonly asked questions. Headache, 52(4), 716-717. doi:10.1111/j.1526-4610.2012.02121.x