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Botulinum toxin is a medication that has been used for the treatment of severe cases of muscle spasms and also in cosmetic dermatology and plastic surgery for the treatment of facial wrinkles. For pain patient who have had partial and short lasting response to trigger point injections, Botox could be a reasonable alternative. Also, there is new evidence that some forms of migraine headache that have been refractory to other treatment may respond favorably to Botox injections.

In this procedure, very small amounts of the diluted medicine will be injected into the areas of significant spasm and trigger points. This will cause those muscles not to be able to contract forcefully and go into spasm. The result is not immediate and usually takes a couple of days to take effect. The treatment can last up to 8-12 weeks. These injections may be repeated. Some patients may experience flu like symptoms temporarily. The actual procedure is very much like trigger point injections except for the medication used.