How Does BOTOX® for Spasticity Work?

When you think of BOTOX®, you might imme­di­ate­ly think of injec­tions to address signs of aging like wrin­kles, fine lines, or sag­ging eye­brows. But did you know that the uses of BOTOX don’t end there?

BOTOX, one of the most well-known brands of bot­u­linum tox­in injec­tions, is often used for cos­met­ic pur­pos­es, but it can also be very effec­tive in treat­ing symp­toms of cer­tain med­ical conditions.

Here are answers to some com­mon ques­tions about using BOTOX for spasticity.

What Is Spasticity?

Spas­tic­i­ty, also referred to as increased mus­cle tone or unusu­al tight­ness, is rigid or stiff mus­cles. It occurs when your mus­cles tight­en or stiff­en, which makes your body move­ments less flu­id than nor­mal. It can stand in the way of move­ment, speech, and gait (how you walk). In most cas­es, it’s caused by dam­age to the parts of your brain and spinal cord that are respon­si­ble for con­trol­ling move­ment and stretch reflexes.

Spas­tic­i­ty affects every­one dif­fer­ent­ly, and there are many pos­si­ble symp­toms that range from mild to severe. Com­mon symp­toms include:

• Abnor­mal posture
• Stronger or more exag­ger­at­ed reflex­es (e.g., knee-jerk reactions)
• Pain, tight­ness, dis­com­fort, or a defor­mi­ty in the affect­ed body part
• Mus­cle spasms (invol­un­tary mus­cle contractions)
• Repet­i­tive jerk­ing motions, par­tic­u­lar­ly after being touched or moved
• Unin­ten­tion­al­ly cross­ing your legs
• Mus­cle stiff­ness, which can make it dif­fi­cult to per­form every­day tasks like bathing or get­ting dressed
• Car­ry­ing your fin­gers, arms, wrists, or shoul­ders at abnor­mal angles
• Speech prob­lems (if spas­tic­i­ty occurs in your mouth, face, or throat muscles)

What Is BOTOX? Is It Safe?

BOTOX injec­tions are shots of a tox­in that comes from the bac­teri­um Clostrid­i­um bot­u­linum. Try not to let the word ​“tox­in” scare you. While BOTOX is made from the same tox­in that caus­es bot­u­lism (a life-threat­en­ing type of food poi­son­ing), the form of the tox­in used in injec­tions is puri­fied. BOTOX injec­tions have been cleared by the US Food and Drug Admin­is­tra­tion (FDA), which means that they are safe if used correctly.

There are some pos­si­ble side effects, like pain or sore­ness at the injec­tion site, headache, or indi­ges­tion. For­tu­nate­ly, these are usu­al­ly mild and go away with­in a day or two. It’s rare for side effects to be serious.

Also read: 5 Things You Need to Know About BOTOX® Safety

How Does BOTOX Treat Spasticity?

BOTOX tem­porar­i­ly blocks the chem­i­cal sig­nals from nerves that make your mus­cles con­tract. When used for cos­met­ic pur­pos­es, this relax­es your facial mus­cles to pre­vent wrin­kles and frown lines.

When treat­ing spas­tic­i­ty, BOTOX reduces tone in the mus­cles that are caus­ing spasms or tight­ness. This allows your mus­cles to loosen up, result­ing in bet­ter range of motion and reduced stiffness.

What Should I Expect When Get­ting BOTOX?

Your provider might give you med­ica­tion to numb the treat­ment area. Even if you don’t get numbed, remem­ber that a BOTOX injec­tion feels like oth­er shots – it might sting a bit or be uncom­fort­able, but the pain is min­i­mal and it’s over before you know it.

Since BOTOX is an out­pa­tient pro­ce­dure, you can go home after, with no hos­pi­tal stay need­ed. In most cas­es, you can imme­di­ate­ly jump right back into work or oth­er activ­i­ties. How­ev­er, you shouldn’t lay down for 2 – 4 hours after the injec­tions to pre­vent the BOTOX from spread­ing to areas that don’t need it.

There are sev­er­al ways to reduce red­ness, swelling, and bruis­ing after BOTOX:

• Don’t rub or put pres­sure on the treat­ment area for 12 hours
• Avoid heavy phys­i­cal activ­i­ty for 24 hours 
• Put a cool com­press on the injec­tion site for 10 min­utes at a time
• Don’t drink alco­hol or take NSAIDs (like aspirin, ibupro­fen, and naprox­en sodium)

If you’ve had BOTOX for cos­met­ic pur­pos­es, you might be used to see­ing results with­in a cou­ple of days. For spas­tic­i­ty, it some­times takes a lit­tle longer (pos­si­bly 10 to 14 days). BOTOX usu­al­ly lasts for about 3 to 4 months, so you will need to get reg­u­lar fol­low-up injections.

Who Is – and Is Not – a Can­di­date for BOTOX?

While BOTOX is safe and can be a high­ly effec­tive treat­ment, it’s not right for every­one. You should not get BOTOX if you have neu­ro­mus­cu­lar dis­ease, droop­ing eye­lids, weak facial mus­cles, or if you are preg­nant or breast­feed­ing. Also, BOTOX might not be as effec­tive if you have wide­spread spas­tic­i­ty – it’s gen­er­al­ly rec­om­mend­ed for those whose spas­tic­i­ty is lim­it­ed to just a few mus­cle groups. 

Does Insur­ance Cov­er BOTOX?

When you get BOTOX for cos­met­ic pur­pos­es, it’s gen­er­al­ly not cov­ered by insur­ance. But when BOTOX is for med­ical pur­pos­es, like treat­ing spas­tic­i­ty, it’s a dif­fer­ent story.

Learn about cos­met­ic BOTOX at South Bend Clinic

Medicare and pri­vate insur­ers typ­i­cal­ly cov­er BOTOX as long as you’re using it as a med­ical treat­ment. How­ev­er, it’s always a good idea to dou­ble-check with your insur­ance before sched­ul­ing an appoint­ment to make sure they don’t have any restric­tions. For exam­ple, Medicare requires a let­ter from your provider with your diag­no­sis and con­fir­ma­tion that first-choice treat­ment meth­ods were unsuccessful.

Also, learn about out-of-pock­et costs (like copays or deductibles) ahead of time so there are no sur­pris­es. If you don’t have insur­ance or if out-of-pock­et costs are too high to pay at once, talk to your provider’s office about pay­ment plans to make it more affordable.

What Are Oth­er Treat­ments for Spasticity?

If you’re not a can­di­date for BOTOX, there are plen­ty of oth­er treat­ment options. Even if you do get BOTOX, you will like­ly need to com­bine it with anoth­er form of treat­ment, such as:

• Phys­i­cal, occu­pa­tion­al, or speech therapy
• Assis­tive devices to help you move
• Casts or braces to improve range of motion and function
• Pre­scrip­tion medications
• Surgery (if spas­tic­i­ty is severe)

Try not to get dis­cour­aged if your spas­tic­i­ty doesn’t get bet­ter right away. It might take a lit­tle tri­al and error to find the right treat­ment or com­bi­na­tion of treatments.

Talk to your provider soon­er rather than lat­er if you have signs of spas­tic­i­ty or if you think that you would ben­e­fit from BOTOX. The ear­li­er you treat spas­tic­i­ty, the less like­ly you are to have long-term com­pli­ca­tions, and the soon­er you can get relief from symptoms.

Take the first step toward bet­ter mobil­i­ty. Sched­ule an appoint­ment with your South Bend Clin­ic pri­ma­ry care provider or physi­a­trist (a spe­cial­ist in pain man­age­ment and reha­bil­i­ta­tion) to deter­mine if BOTOX is right for you.