By Elliot B. Bodofsky MD, Chairman and Chief,
Department of Physical Medicine and Rehabilitation
Spasticity is a muscle control disorder that is characterized by tight or stiff muscles and an inability to control those muscles. Chronic muscle spasticity is a very common condition that can be painful and debilitating. It can interfere with movement, walking, dressing, bathing and sleep. It can also cause joint deformities and skin breakdown. Debilitating chronic spasticity is seen frequently with stroke, multiple sclerosis, cerebral palsy, brain injury and spinal cord injury as well as alone in such conditions like chronic neck spasm or writer’s cramp.
Fortunately, there are multiple effective ways to treat chronic muscle spasticity. For some patients, applying a hot pack helps. Physical therapy is another alternative that can teach patients exercises to maintain movement and relieve pain.
Other treatments include medication to reduce spasm. Some respond well to anti-spasm pills. With severe spasm, medications often do not work. There are frequent side effects, including fatigue, dizziness and dry mouth.
For those who do not respond to physical therapy or medications, or who suffer from the side effects of medications, there is another option: Botox® injections, which are used to help relax tight, spastic muscles. The procedure takes about 30 minutes, and patients can go back to work immediately. Usually only the severely tight muscles are treated. The large majority of patients experience a major reduction in muscle spasm about one week after treatment. This last for about three to four months and can be repeated an unlimited number of times. Almost any muscle can be treated.
Some patients do not respond to Botox because they are genetically resistant. In these cases there are two other injectable medications, Myobloc® and Dysport®, which usually work.
After Botox treatment, about one patient in 100 develops a rash near the injection site. Some patients experience dry mouth or dry eyes. In rare circumstances, or about one patient in 2000, there are more serious reactions such as muscle pains and fever.
The results of Botox treatment can be dramatic. In some cases children with cerebral palsy walk for the first time. Stroke patients regain the function that was once lost. Pain is often reduced as tight muscle groups become relaxed.
If you feel that Botox injection would be beneficial for you, a family member or friend, ask your primary care physician for a referral to a physiatrist (specialist in Physical Medicine and Rehabilitation) or neurologist that performs Botox injections or contact local Physical Medicine and Rehabilitation or Neurology practices directly.
For more information, visit tge Cooper University Health Care Department of Physical Medicine and Rehabilitation and Neurological Institute.