Treatment with botulinum toxin (Botox) in pain management is relatively new. Botox initially received approval in 1989 for treatment of strabismus and blepharospasm, conditions which affect the eye muscles. Later on, physicians started using Botox for treatment of spasticity (overly tight muscles) in spinal cord injury, stroke, multiple sclerosis, cerebral palsy. Use of Botox in those conditions is now considered routine. Of course, we are all aware that Botox is used for cosmetic reasons.

Botox has been used for muscle pain for the last 10 years with beneficial results. Patients with cervicothoracic muscle pain and degenerative changes of the spine could be candidates for Botox injections, as well as patients with delayed recovery from spine surgery. Botox injection is a treatment option for whiplash syndrome of neck. Whiplash syndrome occurs after car accidents and causes neck pain and muscle spasm. The pain relief from Botox injection varies from six to nine months. The dose of Botox used depends on the muscle size.

Botox is a safe medication. Possible side effects of botulinum toxin include flu-like symptoms and temporary muscle weakness. The toxic dose of Botox is one hundred times greater than the therapeutical dose.

In addition, the American Academy of Neurology has approved the use of Botox for migraine headaches.