Edward Magaziner, MD, CEO, New Jersey Interventional Pain Society, Assistant Professor, New York Medical College, Clinical Professor, Robert Wood Johnson University Dept. of Anesthesia and PM&R, Medical Director, Center for Spine, Sports, Pain Management, and Orthopedic Regenerative Medicine, North Brunswick, NJ, details the chronic pain conditions he has successfully treated with Botox (onabotulinumtoxinA).
Aside from the drug's well-known cosmetic indications and its effectiveness in treating chronic migraine, Magaziner says Botox can be helpful in treating patients with chronic spasms and chronic nerve pain. For the latter group, Magaziner notes clinical studies have shown Botox injected in a grid-like fashion over the vicinity of a painful nerve decreases "some of the central sensitization that can occur after chronic nerve conditions." For chronic spasms, pain management physicians can inject Botox in the motor end-plate of a patient's muscle fiber to relieve spasticity caused by stroke or spinal cord injury, or to relax neck muscles and stop spasms in torticollis, Magaziner says.
"For people that have just some terrible spasms — who are not getting better through the use of physical therapy, massage, acupuncture, or some of the other techniques we use — when I have a last resort situation, I can always refer to Botox," Magaziner says.
Ted W. Jones, PhD, Clinical Psychologist, Behavioral Medicine Institute, Knoxville, TN, discusses how a primary care physician can implement behavioral medicine principles when treating a pain patient.