Discussions that mention botox

Pain Management board

Hi JohnSmith, I fell for you because I suffer from cervical dystonia which has left me permanently disabled. My muscles spasms are in my neck and I haven't found anything to control them completely. My left arm is now locked into a position where my left hand touches my shoulder and everything doctors tried didn't help. I've even had Botox shots which was a waste of money because they didn't help. Everytime the weather changes or we have severe weather they get so bad that my shoulder draws all the way up to the point my shoulder touches my chin. It can stay this way for at least 8 hrs or more. At times the spasms run down my back and into the other shoulder as well. The only thing that really helps is, I take Soma 350 mg 4 x a day which pretty much keeps them under control. I also have to limited what I can do and what I can't do. I hope you can find someone to help you soon because they will keep getting worse until they can leave you disabled. A neurologist was the person who gave me the Botox shots. Dystonia is due to nerve damage in the muscle so maybe you can find a neurologist who can help you or recommend someone who can. So please, keep trying to find a neurologist or pain specialist the can help you.
Thanks rayefaye! I am disabled with my back as the pain is severe and standing or even sitting makes it worse. There are many forms of dystonia including blepharospasm. Like most chronic pain conditions there is so much that is still unknown. It is an area of medicine in the dark ages.

I had my first 2 series of Botox injections and they were very succesful. The worst pain for 9 years was my lower back and now it is now fairly quiet. It was because after the first set I found a hypertrophied muscle deep next to the spine between two lateral facet joints.

I am now in severe pain in my mid-back because I had to stop my Buspar because of side effects.

I am surprised the Botox did not help you as cervical dystonia is one of only two conditions for which Botox is approved. It has to be injected into large muscles and often in several places.

I hope you can find treatment that helps you more.
"Unfortunately I am having a hard time finding someone to do the injections"

John, what kind of injections are you asking about? I read in your last post you have had botox.

I was offered Botox for cervical dystonia and haven't gone through with it yet.

I have a pain doc but he has gotten so busy that it is hard to even get in and then it is long waits. Together we worked out the first series of injections. Janet Travel MD wrote the book on it (she was Pred. Kennedy's physician). They are called trigger point injections and must be given into the muscle in spasm. Steroids are toxic to the muscle and skin so are not used. Epinephrine is not used. The concentration must be at or below 0.5% or it is toxic to the muscle. We ended up using a mixture of 2% lidocaine (short acting) and 0.5% Marcaine in a 1:3 mixture. This decreases the lidocaine to 0.5% and does not decrease the Marcaine that much.

It seemed that some muscles were resistant to this but I suspect the technique could have been better. The Botox was much more effective but it is very expensive and we do not know if insurance will pay for it yet.
Hi Kim, sometimes it makes me sleepy in the afternoon and I take a short nap since I on disability that's no problem. But I've been on them close to 4 yrs now so I use to the effects from them. This dosage also keeps the spasms down to where I only get them real bad when the weather changes. Then sometimes they get so bad they go all the way down my back and leave me bent over. Then I have to go to the ER and get a shot to relieve the spasm. As far as getting a Botox shot, a neurologist did mine and it didn't take that long but it didn't help me at all. In fact, he injected it close to where I suffer from nerve damage in my arm and shoulder and it hurt more than anything. Due to the cost of a shot which was $1800 and it didn't really help me any, I never went back and had another one. Also you have to repeat the Botox injections every 3 months and if insurance don't help pay that's a lot of money.
According to Travell, the muscle stays in spasm because when in spasm the muscle lacks blood supply and builds up unknown toxins. The key is complete relaxation of the muscle bundle.

The key to the regular injections is piercing the wall of the muscle bundle. The spasm is then immediately released and can potentially end the spasm in that bundle for good. The injections are just to help with the post-injection soreness.

The Botox is different as it completely blocks neuromuscular transmission. In very small muscles it does not have to be injected into the muscle. It seems that in larger ones it does.

In terms of how long it lasts, I had a set of regular injections a year ago and the spasm has not returned. Since the Botox injections are new, I do not know if the spasm wil return in 3 months when the Botox wears off or if there will be long lasting release.