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Is Botox Really An Effective Remedy For Chronic Pain?

Discussion in 'Anesthesia' started by Hadeel Abdelkariem, Jul 8, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

    Apr 1, 2018
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    I'm sitting in my neurologist's office discussing treatment options for my hemiplegic migraines. I've tried shoulder straps, heat packs, massage, yoga, dietary changes, alcohol abstinence and a host of medications – but nothing seems to really work.


    Today my neurologist suggests Botox injections and my crow's-feet immediately stand to attention. "The correct name is botulinum toxin type A," he clarifies, in that vaguely irked way people can get when a vacuum cleaner is called a Hoover.


    'When the Botox starts to work and that chronic pain goes away, it changes everything.'

    It gets me thinking: what other health ailments can be treated with Botox? I do what any curious person does at 2am and get busy on Facebook. "Has anyone had any health issues treated with Botox?" Out goes the question, and in comes an unexpected avalanche of responses. People I haven't spoken to in decades share how it helps with their prolapsed bladder, excessive sweat issues, Tourette syndrome symptoms and wine-induced rosacea. And, of course, their migraines.

    One such friend, Lynnette Turner, 49, experienced years of bruxism in her jaw accompanied by ongoing migraines, until Botox stepped in. "It definitely works for me," she says. "I physically can't clench my jaw any more, so my headaches have disappeared entirely. I didn't realise how much pain I was in until I had Botox."

    Neurologist Dr Jason Gu explains how Botox works: "It blocks the release of the neurotransmitter, acetylcholine, from cholinergic motor and autonomic nerves. When injected into muscle, it can provide relief from spasm. When injected under the skin, it can reduce sweat gland secretion."

    So if Botox can make such a difference, why don't more people know about it? Gu says part of the problem lies in awareness.

    "I find that many patients and their GPs are unaware that a referral to the correct specialist may help them to access the botulinum toxin through the Pharmaceutical Benefits Scheme, which significantly reduces the cost.

    "However, this is on the basis that the patient has specific conditions. These include muscle spasms around the eyes, face and neck, excessive sweating, spasticity following stroke and chronic migraines."

    Gu adds that Botox treatment is not off limits for other ailments. "We still may try injections in some situations that are not covered by the Pharmaceutical Benefits Scheme, such as spasticity in tremor, multiple sclerosis, and sialorrhea – which is excess saliva production."

    It is not just neurologists who can deliver Botox treatments. Gu says: "Ophthalmologists can give treatment for spasm around the eyes, dermatologists can give injections for sweating, while urologists can give injections in certain cases of urinary incontinence."

    Lynnette Turner believes the increased use of Botox for therapeutic purposes is partly fuelled by social media momentum.

    "I first heard about Botox as a migraine treatment from people in closed Facebook groups," she says. "Now I want more people to know about it. When the Botox starts to work and that chronic pain goes away, it changes everything. You can't explain that feeling."

    Gu says that this sense of wonder is not unusual. "People have been living with these conditions for so long that they become accepting of the symptoms. This is despite the tremendous impact that botulinum toxin can have on both their social and their professional lives."

    After decades of migraines, I'm looking forward to my next appointment. A bunch of needles injected into my scalp, neck and shoulders is nothing compared to the pain of migraines.

    This article appears in Sunday Life magazine within the Sun-Herald and the Sunday Age on sale June 30.


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