Often when you hear Botox, you think about removing those fine lines and wrinkles on your face to age gracefully. However, it has more usability than improving your face. Botox also can help with pain, spasticity, dystonia, chronic migraine headaches, urinary control, your sex life, excessive sweating and more.
Marshfield Clinic Health System offers Botox services for all of these purposes at some of our locations.
Botulinum toxin, also referred to as the brand name Botox, works as a muscle paralytic agent by interfering with the normal physiological mechanism at the neuromuscular junction, said Dr. Swati Biswas, physical medicine and rehabilitation provider with Marshfield Clinic Health System. She said Botox treatment is typically effective for 12 weeks after which it needs to be repeated.
“Botox doesn’t work for everyone, but it is definitely worth trying in the patients who qualify,” Biswas said.
Botox eliminates migraines
Dealing with migraines can have a serious impact on your quality of life. Botox is approved for chronic migraines with 15 or more headache days per month, eight of which are migraines.
Biswas says this treatment is used only if the patient has not responded to an adequate trial of more than one prophylactic medication and their symptoms are significantly debilitating.
“Patients must meet certain criteria in order to qualify for Botox treatment,” she said.
For migraine headaches, the thought is that Botox works by reducing the uptake of certain neurotransmitters that are involved in the pain pathway. Typically, there are 31 injection sites at each visit in the head, neck, temples and face.
“The procedures are invasive,” Biswas said. “Fine needles are involved and there are risks of bleeding, bruising, facial asymmetry, flu-like symptoms, swallowing difficulties, infection, muscle weakness and allergic reactions.”
Reduce muscle spasms
Spasticity is due to over-activity in certain muscle groups as a result of brain or spinal cord dysfunction. Botox can weaken those overactive muscles and thereby improve function, restore a more normal balance and reduce pain.
Biswas advises that Botox treatment is used in conjunction with physical and occupational therapy, exercises, medication and braces to help the patient through recovery.
Marshfield Clinic Health System’s Dr. Katie Spangler is a movement disorder neurologist with training specifically in Botox. She performs injections for muscle tightness, neck spasms, small muscle spasms, facial spasms, eye twitching, migraine, contractions of the face, jaw and tongue and excessive drooling or salivation. All these conditions are movement disorders in which a person’s muscles contract uncontrollably or cause pain.
“Botox without a doubt can improve quality of life for patients that suffer from movement disorders,” Spangler said. “It can allow them to more easily watch TV, drive, sit at a computer, talk on the phone and be less embarrassed in public or in social settings.”
The treatment can be given at 15 to 20 sites. The amount used as well as the distribution of the medication is variable depending upon the extent and distribution of spasticity in the patient.
“Sometimes the Botox injections are done under electromyographic (EMG) guidance for spasticity patients and for dystonia patients,” Biswas said.
Regain intimacy and urinary function
Dr. Barbara Coulter-Smith, OB/GYN physician with Marshfield Clinic Health System, said Botox can help with female sexual dysfunction or pain during sex. By injecting it into the vaginal region, those muscles that contract will relax to alleviate pain.
The treatment plan will depend on the patient and their needs. It make take a few sessions in order to see improvement, but Coulter-Smith said many patients see results after the first session. Appointments may be as frequent as needed and tend to decrease as time goes on.
“Botox can be used for pelvic floor dysfunction, often in coordination with a pelvic floor physical therapist for chronic pelvic floor pain, dyspareunia and vaginismus,” said Coulter-Smith. “It is an ‘off label’ use for Botox but more and more studies are coming out showing its effectiveness, and with appropriate patient selection, it can be quite helpful to patients.”
Manage excessive sweating
Though increased weather temperature or physical activity can cause sweating, some people suffer from excessive sweating or hyperhidrosis.
Botox injections block the nerve signals responsible for sweating, stopping the sweat glands from producing too much sweat. Retreatment is typically needed in four to six months, as the nerves regenerate.