Botox Used to Treat More Than Just Wrinkles

Botox used to treat more than just wrinklesMADISON - You probably know it as the amazing wrinkle eraser, a product used both by Hollywood's rich and famous and those who don't mind spending money to look a little younger.
But Botox—also known by its scientific name, botulinum toxin—has a host of other medical uses that might not be so familiar. To these patients, Botox provides needed relief for some very serious conditions.
Shortterm Relief for Stiff Muscles
Anyone who's ever suffered accident-induced whiplash knows the pain it can wreak on neck and upper back muscles. If the damage is serious, the injured and tightened nerves can make even simple movement impossible.
A handful of times each month, James Leonard, MD and the team at UW Health orthopedic rehabilitation use Botox injections to relax muscles in patients' necks and scapula area. If the patient is suffering from migraine headaches and or jaw pain, Botox can also help with that.
And yes, Dr. Leonard gets plenty of cosmetic jokes.
"When people get their first injection, they're always asking me, 'If there's any left over, can you use it to erase my wrinkles?'" says Leonard.
Botox is not a first-line treatment for stiff muscles—physical therapy and surgery fill that role—but for patients who need shortterm relief during the healing process, it can be quite effective. Unlike some of the other Botox therapies described below, it's not a long-term solution. Three or four injections, several months apart, is the generally approved course of treatment.
"Botox isn't meant to be used for years and years," says Leonard, who notes that it's an expensive therapy: A few ounces costs as much as a thousand dollars. "You have to be careful not to make the muscles weak."
Researchers in orthopedics are currently conducting trials to see whether Botox can have a similar effect on painful joints. For now, however, neck and back-pain sufferers are happy to take advantage.
Says Dr. Leonard: "You’re dealing with individuals who have been in pain for six months. They just want relief."
Vocal Restoration
About 50,000-70,000 Americans suffer from spasmodic dysphonia, a fancy term that describes a maddening condition—a neuromuscular disease of the larynx that turns a normal voice into a scratchy, strangulated one.
"This condition is very debilitating from a social and professional standpoint," says Seth Dailey, MD an otolaryngologist with UW Health. "People say their friends and family think they're crazy, because they can't stop talking in a strangled way."
Botox can help significantly. Using a needle with an attached electrode, Dr. Dailey can inject Botox into the muscle of the vocal cord, temporarily weakening it and returning the voice to normal. As with its other applications, Botox's effect isn't permanent.
Patients come in for repeat injections once every 3-12 months, depending on their circumstances. Most don't seem to mind the inconvenience of multiple injections, says Dr. Dailey, who also uses the drug to treat vocal tremor and hypersalivation.
"Once they see a response, they want to use Botox again. They can tell when their symptoms are returning."
Help for Hyperhydrosis
Imagine that your hands sweat. Constantly. To the point of dripping and ruining the pieces of paper you pick up every day.
That's reality for people with hyperhydrosis, a malady in which the sympathetic chain, a series of glands that regulates the dispensation of sweat throughout the body, stops doing its job.
Physicians don't know exactly why Botox works to combat hyperhydrosis—the notion of loosening nerves and tissues would seem to exacerbate the problem, not fix it—but it does. Starch-iodine tests that measure the amount and location of a person's sweat before and after Botox use prove it.
"We know that Botox blocks the neurotransmitter that tightens muscles," says Molly Hinshaw, MD, a UW Health dermatologist. "It has the same effect in sweat glands as well."
For some patients, a Botox injection at the source of sweating—the palms, armpits or soles of the feet—every six months is all they need to get their sweating under control. Those whose hyperhydrosis is more severe may require a surgical option called a sympathectomy.

Date Published: 02/29/2008

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