Botox for spasticity
The same neurotoxin used to diminish the appearance of wrinkles may now help smooth the frustration of patients with upper motor neuron syndrome-related spasticity following stroke, spinal cord injury, traumatic brain injury, cerebral palsy, or multiple sclerosis.
When muscles no longer respond to signals from the central nervous system telling them to relax, they remain contracted instead. Examples of post-stroke spasticity include a clenched fist, flexed wrist, bent elbow, or arm pressed against the chest.
All botulinum toxins (A-G) are powerful neurotoxins that temporarily weaken muscles by inhibiting acetylcholine release, which signals muscles to contract. They relax the affected muscles, reducing spasticity and helping patients function more normally, with improvements in hygiene, dressing, and pain.
Trigger point injections
Trigger point injection (TPI) is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.
Referred pain from trigger points can mimic pinched nerves in the neck or low back. They can occur from direct muscle injuries, poor posture, repetitive strain, or secondarily from spine conditions such as a herniated disc.
In the TPI procedure, a physician inserts a small needle into your trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief.
Injections are given in our office and usually take just a few minutes. Several sites may be injected in one visit. If you have an allergy to a certain medication, a dry-needle technique (involving no medications) can be used.
A joint injection (intra-articular injection) is used in the treatment of inflammatory joint conditions, such as rheumatoid arthritis, gout, tendinitis, bursitis and occasionally osteoarthritis.
A hypodermic needle is injected in the affected joint where it delivers a dose of any one of many anti-inflammatory agents, the most common of which are corticosteroids.