Is Botox an effective treatment for spasticity after stroke?
Following a stroke, miscommunication between the brain and muscles can cause the muscles to involuntarily contract and become stiff, a condition known as spasticity. One way to relax the muscles is to use Botox.
Most patients aren’t told exactly how Botox works, so they only see short-term results. This article will show you how to turn your temporary gains from Botox into lasting relief.
Botox for Spasticity After Stroke
Spasticity is a condition where the muscles become stiff due to prolonged muscle contraction after neurological injuries like stroke. Patients may feel like spasticity is a problem with the muscles, but the problem stems from miscommunication between the brain and the muscles.
When a stroke damages the motor cortex, it impairs the brain’s ability to tell the muscles to either contract or relax. This miscommunication can cause multiple muscles to contract at once without being able to relax, causing spasticity.
By injecting Botox directly into the muscles that are affected, spasticity can be significantly reduced. Botox (botulinum toxin A) works as a “nerve block” that blocks the release of chemicals that signal your muscles to tighten. As a result, your muscles relax.
This study found that reduction in spasticity was associated with significant improvement in arm function after stroke. It suggests that a moderate dose of Botox helps reduce spasticity long enough to allow for functional improvements without causing a significant decrease in strength.
However, it’s important to understand that Botox is not a permanent fix. Because it does not address the underlying cause of spasticity, Botox only provides temporary results. Once injected, its effects generally last about 3-6 months. Unless you get another injection, spasticity will return.
By taking advantage of the reduced muscle tone while using Botox and focusing on the root cause of spasticity (restoring the brain-muscle connection), individuals can achieve long-term spasticity relief.
In the following section, we’ll address some side effects associated with Botox.
Side Effects of Botox for Stroke Patients
While Botox can be an effective form of spasticity treatment for stroke survivors, there are potential side effects you should be aware of.
Common side effects of Botox include:
- Muscle weakness
- Joint pain
While general soreness and bruising near the injection site are normal, more serious complications like muscle weakness, difficulties breathing, vision problems, and loss of bladder control warrants immediate medical attention. Call your doctor if you experience these complications after your Botox injection.
In the following section, we’ll discuss how to take advantage of Botox to promote more permanent relief.
How to Maximize the Benefits of Botox for Stroke Patients
Botox becomes a temporary treatment when you don’t use it in conjunction with physical therapy to restore your brain-muscle communication.
It’s kind of like using pain killers for a broken ankle without wearing a cast. The painkillers will make the pain go away, but you aren’t doing anything to heal the root problem.
That’s why it’s important to treat spasticity on both levels: relieve the symptoms temporarily with Botox and cure the root cause long-term by doing rehab exercises.
Using Botox without participating in physical and/or occupational therapy will make the treatment temporary. But if you use the effects of Botox to create an opportunity to exercise, then you can see long-term results.
Recovery after stroke is possible because the brain is can utilize neuroplasticity. Neuroplasticity is the central nervous system’s ability to reorganize itself based on your behaviors. Consistently practicing movements affected by stroke will help promote rewiring of those functions to healthy, undamaged regions of the brain. As a result, those movements will no longer be affected by spasticity.
Botox loosens your muscles so that you can move in the short term, and rehab exercise will reinforce demand and promote neuroadaptive changes in the brain so that you can keep moving in the long term.
The Doctor’s Word on Botox for Stroke
Ross Bogey, DO, says that Botox may indirectly help with stroke rehab, especially for patients who can’t undergo therapy because of spasticity. The keyword here is indirectly.
Botox itself doesn’t resolve spasticity long-term – it simply creates the opportunity to exercise, which can improve your spasticity for good.
WebMD quoted him saying, “We often use Botox to reduce spasticity so patients can participate in therapy that leads to … recovery.”
In other words, Botox creates the opportunity to exercise, and exercise is what leads to recovery from spasticity.
So overall, Botox is an excellent treatment for spasticity when used as an opportunity to move your affected muscles and rewire your brain.
Botox alone creates temporary results. But Botox coupled with rehabilitative exercise creates lasting results.
Botox for Stroke Patients: Key Points
If you’re experiencing spasticity after a stroke, Botox may be an effective solution. However, it’s essential that you take advantage of its muscle relaxing effects and participate in intensive rehabilitative therapies to promote long-term spasticity relief.
Without addressing the underlying cause of spasticity, individuals will only experience short-term relief.
We hope this article helped you better understand what Botox is and how to use it to effectively treat spasticity. Good luck!
Photos from top to bottom: iStock/scyther5/Tero Vesalainen/LSOphoto