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Pediatric Update

 
Summer 2005

Botox Eases Pain in Head and Neck

People whose job causes them to overuse their shoulder and neck muscles— as is often the case for workers who spend most of their time in front of a computer—are particularly prone to nagging pain caused by localized muscle spasms, explains Michael Ferrante, M.D., director of UCLA Pain and Spine Care. “Often, there is nothing structurally wrong with the neck that would be amenable to surgery; it’s just an injury to the soft tissue from overuse,” Dr. Ferrante says. “In some patients, conservative treatments for this type of pain may provide either temporary relief or no relief at all.”

Botox, derived from the bacterium known as clostridium botulinum, is extremely safe when administered by an experienced physician, Dr. Ferrante notes. He explains that for patients with intractable soft-tissue pain in the head and neck, Botox works both directly and indirectly. It relaxes the muscles by reducing the release of the neurotransmitter acetylcholine. And within the last year, Botox has also been found to have a direct analgesic effect.

A myofacial pain specialist can determine which muscles are causing the problem and inject the drug into appropriate places. “Most importantly, do not use Botox alone, but in conjunction with physical therapy,” Dr. Ferrante says. “You relax the muscle and then get it supple again; it can’t relax during the period of pain and spasm.” Unlike the cosmetic use of Botox, in which patients need to return approximately every six months to maintain the effect, Dr. Ferrante has found that most of his patients find long-term relief in two or three treatments.





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