Botox® Treatment Options for Headaches and Spasticity

SMC offers Botox® injections for Spasticity which is common for Multiple Sclerosis Patients

Botox® is a muscle relaxing medication that is approved by the FDA to treat upper and lower limb spasticity in adults as well as urinary incontinence resulting from overactivity of the bladder caused by MS or another neurologic condition. Botulinum toxin is a medication derived from a neurotoxin produced by bacteria (Clostridium Botulinum). In its natural form, this toxin causes botulism, a severe condition that can be fatal. Botox® is designed to be used safely without causing botulism. 

Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and can interfere with normal movement. Spasticity can also cause muscle spasms (jerky involuntary movements) or clonus (repetitive involuntary movement). Stiffness and spasms are often bothersome and sometimes painful and they can interfere with the ability to carry out daily activities. Spasms may also disrupt sleep and increase daytime fatigue. When spasticity is severe, contractures (fixed limitations of range of motion) may develop.

Stretching, exercise and PT/OT are usually the first treatments for spasticity. Oral medications are often effective but may cause side effects such as drowsiness. When spasticity affects only a few muscles, local injections of Botox® can be helpful. When several muscles are affected other options should be discussed. 

Normally, the brain send messages to the muscles so they can contract and move. These messages are transmitted via the nerves to the muscles by a substance called acetylcholine. Botox® blocks the release of acetylcholine from the nerve to the muscle, leading to short-term localized relaxation of the targeted muscles. 

Botox® is given as an injection into the muscle. The injections are given during an outpatient visit. Your healthcare provider will determine beforehand which muscles need to be injected. Because Botox® doesn’t travel far from the injection site, several injections are performed during one visit. Often times a machine called an EMG is used to help locate the correct muscle.

The effect of botulinum toxin is expected to last 2-6 months then gradually wears off. Maximum response is usually met at 4-6 weeks and lasts 10-12 weeks. Sometimes PT or OT are needed to maximize the benefits of BT. It is always necessary to stretch and exercise at home. 

Both of Saunders Medical Center's providers in Wahoo, Nebraska are trained to administer these injections. They will treat patients on a case-by-case basis but, in general, the injections are given every 90 days to patients with upper and/or lower limb spasticity that is unresponsive to oral medications. They will work closely with the physical therapy department throughout the process. SMC's Physical therapy will perform an evaluation that includes: manual muscle testing, range of motion, a video gait analysis, spasticity index using the Ashworth scale, pain assessment and a standardized assessment of the limb(s).

Our office provides Botox® injections for spasticity and migraine headaches. We can refer you to another provider if it is determined that Botox® for urinary problems is needed.

Call 402 443-1456 to schedule an appointment.