Botulinum Toxin Injection

What is the purpose of it?
The botulinum toxin injection may be used to treat cervical dystonia (neck muscle spasms), migraine headaches, upper extremity spasticity, overactive bladder, and certain muscle and pelvic pain conditions.

How long does the injection take?
The injection(s) may take a few minutes up to half an hour to perform.

What is actually injected?
The injection consists of a toxin made from the bacterium, Clostridium botulinum, and is commercially manufactured (onabotulinumtoxinA – Botox®) by Allergan.

Will the injection(s) hurt?
The procedure involves inserting a very thin needle through skin and/or deeper tissues. So, there is minor discomfort involved.

Will I be “put out” for this procedure?
No. This procedure is usually performed in the doctor’s office. Occasionally, it may be done in a facility if sedation becomes necessary, or imaging techniques requiring specialized equipment are necessary.

How is the injection performed?
It depends on the body part involved. Positioning requires access to the affected area. The skin is cleaned with antiseptic solution and then the injection is carried out.

What should I expect after the injection?
Immediately after the injection, you may feel sore in the area injected. When used to treat migraines, sometimes a migraine headache is triggered by the injection. Botulinum toxin usually takes about 7 days before it become effective. If injected into and around muscles, you may notice paralysis of small groups of muscles, such as in the forehead or neck, which is expected. Occasionally, there is weakness noted in more distant parts of the body, depending on the dose of botulinum toxin injected. Dry mouth and difficulty swallowing are known side effects as well.

What should I do after the procedure?
You may need to have a ride home. We advise the patients to take it easy for the day of the procedure. You may apply ice to the affected area. Avoid applying heat or massage to the injected area for 48 hours. Avoid heavy activity for 24 hours.

Can I go to work to work the next day?
Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is soreness at the site of injection.

How long does the effect of the medication last?
The duration of action of botulinum toxin is usually 10-12 weeks.

How many injections do I need to have?
Depending on the diagnosis being treated, we often recommend at least two injections (12 weeks apart) before determining that the treatment is ineffective. If it is effective, treatments usually are repeated every 12 weeks.

Will the Botulinum Toxin Injection help me?
It is very difficult to predict if the injection will indeed help you or not.

What are the risks and side effects?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain – which is temporary. The other risks involve muscle weakness, difficulty swallowing, dry mouth, hoarseness of the voice, bleeding and bruising at the injection site, and worsening of symptoms. An overdose of botulinum toxin could result in the condition known as botulism, which can cause paralysis of the muscles of breathing, and lead to death. This does not occur with doses and preparations approved for medical purposes.

Who should not have this injection?
Those who are allergic to botulinum toxin.

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