Botulinum Toxin Injections (Botox Injections)

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The bacteria Clostridium botulinum produces botulinum toxin, which is the same substance that can cause botulism. It may sound alarming, but the medical use of this substance involves an inactive form of the toxin that is several thousand times less potent than the amount required to cause botulism.

There are several toxins produced by the bacterium Clostridium botulinum. Gradual relaxation of muscle spasm develops over one to two weeks after the injection. The reduction of muscle spasm lasts for 3-4 months and pain relief can last even longer. 


Botox botulinum injections (Botox) are used to treat various conditions, including migraine and tension headaches, chronic muscle spasms in the neck and back, torticollis (severe neck muscle spasms), myofascial pain syndrome, and spasticity from multiple sclerosis or stroke. Additionally, Botulinum toxin (Botox) offers beneficial effects for excessive sweating (hyperhidrosis) and bruxism (teeth grinding). In the case of hyperhidrosis, the toxin blocks the nerve signals responsible for sweat production, effectively preventing overactive sweat glands.

For bruxism, Botox is injected into the jaw muscles that are responsible for teeth grinding and clenching. This injection weakens the muscles, reducing their ability to contract forcefully. As a result, the symptoms associated with bruxism, such as jaw pain, headaches, and tooth damage caused by grinding, are alleviated.


The administration of Botox injections can take place either in our office or at our outpatient surgery center. The choice of location depends on factors such as the size and location of the muscles being injected, personal preference, and insurance coverage. You may discuss your options with your physician as well as options regarding sedation.

During the office session, healthcare providers will request that you change into a gown and lie down on an examination table. They will cleanse your skin with a sterile solution before injecting the solution of botulinum toxin, which is mixed with either saline or local anesthetic (numbing) medication, into the muscles experiencing spasms. If needed, our staff will also apply “band aids” over the injection sites.

In an outpatient surgery setting, you will be taken to a procedure room and positioned lying on your stomach on a procedure table.  For injections in deep muscles such as the piriformis, psoas, or scalene muscles your doctor may take x-rays to ensure proper needle placement. A solution of Botox and local anesthetic is then injected into the muscles. You may experience temporary numbness or weakness in a leg with the piriformis or psoas injection or in an arm with scalene injections in the neck. After being monitored in the recovery area, you will be discharged.  If you have opted for sedation medications, you will need a driver to take you home.

Temporary side effects from the injections may include increase in pain, weakness in the muscles injected, body aches, dry mouth, and hoarseness. Your physician will recommend timing for a follow up visit in the office.

For more information about Botulinum Toxin we highly recommend watching the informative Botox Injections video.

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