Botox: Paravertebral Botox In Refractory Back Pain
When people get back pain that is really resistant to conservative or traditional treatments, there used to be very little that could be done to bring about significant improvement, but then up pops Botox and it really is the most amazing substance; even though it is highly poisonous and in large doses even fatal.
Botulism Toxin/Botulinum Toxin
These terms are the common names applied to the protein toxin/poison that is generated by the clostridium botulinum bacteria. In a sense, Botox is not the important factor here, it si actually the poison or toxin that works its magic!
Botox functions in a really complex manner. It breaks down and prevents the neurons in the area injected, from releasing acetylcholine. in addition the muscles are effectively paralysed and what happens is that the nerves and muscles can no longer communicate and combined this means that they are unable of telling the brain that they are experiencing pain. If the brain does not know that pain is being felt, then it naturally assumes that everything is ok and there is a significant reduction in the levels of pain that are being experienced.
Botox And Muscle Pain
The use of Botox for lower back pain is really limited to muscular pain. The Botox is injected into the muscles, directly into the area where pain is being experienced. Given that the amount of Botox being injected is so minute, there is often a series of injections given into several muscles that are thought to be causing pain. The muscles then relax, do not go into spasm and are rendered paralysed. The patients benefit from having pain reduction (usually at least 50% of people with muscular back pain will benefit from Botox injections) and the pain reduction then can enable physiotherapy to be undertaken or at the very least, preventative exercises.
However, Botox will not ‘cure’ a condition such as a slipped or herniated disc. Conditions such as sciatica, which is caused by pressure being exerted on the sciatic nerve, will also be unresponsive to Botox, simply because this is a nerve that is affected, not a muscle.
Botox can only be used to cure muscular back pain. True, patients may find that in the area injected, they have less muscular strength, but if it is a choice between pain and a slight loss of muscle strength in the back, then the choice is usually a straightforward one!
The good news is that muscle pain is the most common back condition in terms of being long term and resistant to treatment. That being said, it is important to recognise that it really is not a miracle cure for all back pain and does have limitations.
The risks associated with Botox for back pain are actually minimal, but it is important that the person administering it is expert in its application; if Botox enters the blood stream it could be potentially fatal, so needs to be treated with extreme caution, expertise and ultimately with respect.