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Botox for Chronic Back and Neck Pain

Is the Fountain of Youth the Answer to Unbearable Pain?

Botox isn't just for celebrities anymore — patients with chronic back and neck pain may want to consider using it. The same injection that works to smooth out wrinkles just may work to relieve persistent, life-inhibiting pain caused by muscle tension.

In fact, Botox was originally approved by the FDA in 1989 to treat severe muscle contractions caused by cervical dystonia. So before Botox was the new "it" anti-aging treatment, doctors knew it could relax muscles. Botox does that by blocking the neurotransmitters that tell muscles to contract. No signal from the neurotransmitters, no contraction, no tension — no pain.

Or at least that's what some pain management specialists have noticed as they treat patients with chronic back and neck pain. Although Botox isn't FDA approved to treat general muscle pain, some doctors do use it.

Dr. Lawrence M. Kamhi, an Interventional Pain Management Specialist at Beth Israel Hospital in New York City, has used Botox as a treatment for his chronic pain patients. "I have administered Botox to some patients suffering from headaches, facial pain, and neck pain due to chronic muscle spasm. I have found it sometimes very helpful. Since the drug is administered locally, there are no systemic side effects like fatigue and sedation as there are with orally-administered muscle relaxant drugs. Botox injections sometimes have to be repeated to maintain a therapeutic effect; patients should note this."

Botox isn't a panacea, though — although on the surface it does seem like a wonder drug. Not only can it be used to keep you looking young, Botox can also be used to relieve your pain: that's a Baby Boomer's dream come true. But before turning to Botox to treat chronic back and neck pain, patients and doctors need to seriously think about several considerations. In addition to Dr. Kamhi's comment about repeat injections, patients and doctors should consider:

  • The price: Although the cost of the injection varies by how much Botox is used, how diluted the solution is, and who is injecting it, this isn't a cheap procedure. The vials of Botox that doctors use cost around $600, and part of that cost is passed on to the patient.
  • The lack of FDA approval: Most likely, the procedure won't be covered by insurance because Botox isn't a typical treatment option for back and neck pain. It is approved for cervical dystonia, so if you are diagnosed with that, your insurance company may cover using Botox as a treatment.
  • The limited research: It hasn't even been 20 years since Botox was first approved for any use. Since then, there have been very few studies that show that Botox can be used specifically for chronic back and neck pain. It's hard to say, then, how effective Botox is, beyond citing anecdotal evidence.

With all that in mind, patients shouldn't rush off to the nearest Botox spa. Instead, they should thoroughly discuss Botox as a back and neck pain treatment option with their doctor.

Updated on: 09/07/12
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