Often times, physical therapy, medications, chiropractic care, myofascial release, and other conservative approaches are not enough in providing the patient with symptom control. At these times, a variety of injection options are available to patients at the Neurology Office.

Trigger Injections

These are injections of anesthetic medication often combined with antiinflammatory medicine. A variety of medications are used. These medications are often injected into a muscle, ligament, tendon or join, to alleviate pain and inflammation, improve range of motion, and ultimately improve function. These injections are rarely the isolated treatment, although they are often effective in allowing the patient to minimize their pain so they can optimize their therapeutic regimen and move forward with their ultimate recovery.

Botox

There are a number of conditions that Botox is ideal for. The classic conditions are muscle dystonia, spasm, with involuntary muscle contractions. This often implies to the head and neck, and is performed at the bedside under electromyographic (EMG) guidance. Botox is botulinum toxin, and is purified toxin that is provided in a dehydrated form. The specialists at Neurology Office will reconstitute the medication, and under appropriate muscle monitoring will inject this in a variety of muscles, to allow the muscles to relax, resume their normal physiologic function, and reduce spasm. Originally utilized in 1968 for facial spasm and spasm around the eye muscle, this has now become quite a bit more popular for additional illnesses.
Migraine: As per the Botox website, it is clear that Botox is a prescription medicine that is injected to prevent headaches in adults with chronic migraines who have 15 or more days each month with headache lasting four or more hours each day in people 18 years or older.

This is the only FDA approved preventative treatment that is injected by a doctor every 12 weeks for adults with chronic migraine.

The medicine often takes 7-21 days for it to be effective, during which time there can be additional stiffness, tightness, soreness in and around the neck muscles or facial muscles. This often resolves. Botox is not for everyone, and a thorough conversation with your physician should be undertaken prior to deciding to move forward with Botox intervention.

Botox for Post Stroke Spasticity

Patients who have suffered a stroke leading to upper limb motor dysfunction, increased tone and spasticity, can now have this addressed with Botox intervention. Under electromyographic guidance, to isolate and identify the affected muscles, Botox intervention to the affected limb can be quite effective. It often is very helpful in relaxing the muscle, reducing tone and spasticity, allowing for improved daily function, improved performance of activities of daily living, and improved ease of use of the affected limb. While this is not a cure, this can often allow the patient to move forward with their comprehensive therapeutic regimen. Despite the chronicity of the stroke and the upper limb spasticity symptoms, Botox can still be quite effective even as a long term intervention for spasticity management of the upper extremity.