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Botulinum Toxin for Pain Management

Vascular Neurology of Southern California Offers Options

Dr. Asif Taqi is a triple board-certified interventional and stroke neurologist with a background in neuroendovascular surgery, vascular neurology and neurocritical care. His experience treating conditions involving cerebral vasculature, neuromuscular and nerve systems is unparalleled and continues to evolve with each passing day.

Here, Dr. Taqi, founder and CEO of Vascular Neurology of Southern California, covers the basics of how botulinum toxin injections may help patients manage persistent pain and live more comfortably.

Let’s begin by defining botulinum toxin. Everyone has heard of it—likely by its mainstream moniker, “Botox”—and its ability to temporarily reduce or eliminate facial fine lines and wrinkles. But that’s not all it does! In fact, botulinum toxin can be found as a treatment option in nearly all medical specialties and has been around for decades helping patients with a diverse set of conditions.

Botulinum toxin is a neurotoxic protein produced by a bacterium called Clostridium botulinum. It works by preventing the nerve signals to the muscle in which it is injected, thereby weakening or paralyzing the site. Health care professionals use a specific serotype of the bacteria, botulinum toxin type A, for medical treatment. The common types of botulinum toxin available commercially include BOTOX®, Dysport®, Xeomin®, and Jeuveau®.

At Vascular Neurology of Southern California BOTOX® injections are offered for the treatment of several conditions:

• Myofascial Pain Syndrome

• Neck Pain

• Temporomandibular Joint Disorder

• Bruxism

• Chronic Headache & Migraine

BOTOX® injections, in treatment of the above conditions, temporarily relieve muscle tension, pain and spasms by blocking signals between the nerves and muscles. For sustained relief, repeat injections will be required. Prior to making any decisions regarding management of a condition, a consultation with an expert is advised to explore options and to better understand the potential risks and benefits of BOTOX® injections.

Myofascial Pain Syndrome

Myofascial Pain Syndrome is a common and chronic pain disorder that affects muscles and fascia. This condition is specifically categorized by the presence of trigger points that cause referred pain. MPS may occur in areas such as the lower and upper back, the neck, shoulders, and chest. While most individuals experience some form of muscle tension throughout their lives, what separates MPS is its persistence and progressively debilitating nature. Myofascial pain syndrome does not resolve on its own and requires treatment for any meaningful relief.

Neck Pain

Neck pain is a prevalent medical condition among adults that can affect individuals of all ages. Neck pain can impact any of the bones, tissues or muscles responsible for range of motion. This condition can be chronic or acute and can limit or interfere with daily life. While most individuals may experience occasional stiffness or soreness in the neck, prolonged and worsening pain can indicate injury or illness and may require medical intervention.

Unfortunately, there is not a single action plan that suits all patients suffering from myofascial pain syndrome or neck pain. Each individual will likely have their own unique set of circumstances that impact their experience.

At VNSC, trigger points injections are offered as a treatment for MPS and neck pain. Injections of BOTOX®, steroids, anesthetic or saline solution to the affected sites may be an option if other standard medical treatments have failed. Common sites of injections include neck, shoulders, back, arms, elbows, lower back, legs, calves and others.

Temporomandibular Joint Disorder

Located on either side of the skull, the temporomandibular joints connect the lower jaw (mandible) to the temporal bone. Its primary function is to act as a hinge allowing the jaw to move to talk, chew and yawn.

TMJ disorders may cause pain in the jaw joints and the surrounding muscles. The pain associated with TMJ disorders may travel through the face, jaw and neck, resulting in stiffness, limited range of movement and, in some cases, inflammation.

Bruxism

Teeth grinding is a relatively common behavior among adults and children. Occasional teeth grinding does not pose a health threat, however, when grinding or clenching occurs on a regular basis, this is a medical condition called bruxism. Bruxism can cause teeth to loosen, fracture or fall out. Patients only become aware of their bruxism when their condition demonstrates severe side effects or complications.

In some patients, TMJ pain and bruxism resolve without medical intervention. However, should symptoms persist, worsen or interfere with daily activities, a physician will likely need to be involved. Depending on the cause and severity of the condition, physicians may offer medications, therapy, dental surgery or trigger point injections to the jaw of BOTOX® or possibly steroids.

Chronic Headache & Migraine

Headaches are an exceptionally prevalent condition that impacts many individuals of all ages around the world. Headaches create unpleasant pain in and around the head, face and upper neck areas, ranging from a temporary nuisance to disabling pain for weeks at a time. Headaches are diverse and may vary in location, frequency, intensity and cause. Likely, if symptoms persist and interfere with daily life, an expert physician will need to be involved.

Migraines are a type of headache that often develop on one side of the head and occur in stages. They often recur and may last anywhere from a few hours to days. Some patients incur warning symptoms prior to migraine onset. Because there is a wide and diverse spectrum of the migraine experience, it is difficult to pinpoint a universal treatment plan.

Treatment options for management of headache and migraine are diverse and include nonpharmacological (i.e., meditation, stress management, acupuncture, etc.) methods, pharmacotherapy (i.e., abortive therapy or prophylactic therapy), or neuromodulation (devices meant to increase or decrease the activity or the nervous system).

Schedule a consultation to discuss tailored treatment options at 805.242.4884 or info@vnsc.org. Visit VNSC.org to learn more.