Botulinum Toxin (BOTOX™)

Botulinum toxin is a protein produced by the bacterium Clostridium botulinum and is a potent neurotoxin.

Botulinum Toxin is a protein produced by the bacterium Clostridium botulinum and is a potent neurotoxin. It is capable of selectively weakening painful muscles and interrupting the pain cycle. Botulinum toxin is a potent chemical that blocks the communication between nerves and muscles and inhibits muscle contractions in the muscles where the trigger points are located, which may result in pain relief when it is injected into the area. It breaks the spasm and pain cycle by blocking the release of acetylcholine. It is also known to have an anti nociceptive effect (pain blocking effect).

Procedure:

BOTOX™ is available as a vial of 100 IU and 50 IU which is injected into various affected muscles under the guidance of Ultrasonography. After a test dry needling (USGDN) of the muscles in the affected areas, doses of each muscle is decided. The doses are very small to prevent any weakness of the injected muscle. The BOTOX™ is injected into the belly and the areas showing signs of presence of myofascial trigger points (MTrPs).

Indications:

All kinds of Myofascial Pain syndromes
Migraine
Cervical Dystonia
Chronic Back pain
Post surgical
Neuropathic pain
Post stroke spasticity
Cerebral Palsy
Diabetic Neuropathy
Post Herpetic Neuralgia

We believe that all pains have a myopathic (muscular) component contributing to the pain even if the origin of pain is neuropathic (nerve related). Muscle is common final expresser of pain in the body. Hence in any pain condition there are multiple trigger points called as myofascial trigger points (MTrPs) in the muscles involved. These trigger points are innumerable cannot be simply targeted by what is called as trigger point injection of steroid. They need to be systematically targeted by Ultrasound Guided dry needling (USGDN) into these muscles. BOTOX™ is facilitative in this process in a way that it makes the process much more comfortable and less painful for the patient and reduces the number of sessions required for complete treatment of pain.

Role of BOTOX™ in Cancer Pains :

Post mastectomy pain
Post Radiation fibrosis
Bony metastasis
Head and Neck Cancer
Abdominal and Pelvic Malignancies – Botox in abdominal wall muscles
Leptomeningeal metastasis – Botox into neck muscles
Metastatic Cancers

Palliative treatment is conventionally thought to be as non invasive as possible and relies more on the usage of narcotic drugs like morphine etc. These drugs make the patients detached from the surroundings in the terminal few days of their life. The family and the caregivers suffer due to the suffering of the patient and also do not get to spend this valuable time with their close one due to the side effects of these drugs. Palliative care can be stepped up by incorporating these minimally invasive and mostly single visit procedures which have lasting pain relief and keep the patients comfortable without any such debilitating side effects. This approach can significantly uplift the quality of life that can be provided to these patients and their families which can have a lasting impact on them.

Botulinum Toxin (BOTOX™)

Procedure:

Indications:

Role of BOTOX™ in Cancer Pains :

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