Conquering Cervical Dystonia: The Power of Intramuscular BOTOX Injections

What is Cervical Dystonia?

Cervical dystonia, also referred to as spasmodic torticollis, is a painful neck disorder characterized by the involuntary contraction of neck muscles. This disorder can also result in the uncontrollable tilting of the head, either forward or backward. Cervical dystonia  can sometimes cause involuntary muscle contractions to spread to adjacent areas of the body such as the face, jaw, and arms. Additionally, those affected by cervical dystonia may experience the development of bone spurs that reduce the space in the spinal canal; this is often associated with sensations of numbness or weakness in the extremities. While it can affect anyone at any age, it is a rare condition that is most prevalent in middle-aged women. 

Cervical dystonia currently has no known cure, and while the condition can sometimes resolve on its own, long-term remissions are rare. However, injecting botulinum toxin into the affected muscles can often alleviate the symptoms of cervical dystonia. A surgical procedure may also be suitable in certain cases.

How is Cervical Dystonia Caused?

Cervical dystonia is often of unknown origin; however, a genetic predisposition may exist in some cases. Notably, GNAL, THAP1, CIZ1, and ANO3 are some identified genes related to onset of the disease. In addition, certain medications, neck trauma, or underlying diseases such as Parkinson's disease may also contribute to the development of cervical dystonia.

What is Botox?

Botulinum toxin, also referred to as botulism neurotoxin, is a protein produced by Clostridium botulinum and similar bacterial species. It is known for its effect on the nervous system, particularly its ability to induce flaccid paralysis by interfering with the release of acetylcholine neurotransmitter from neuromuscular junctions. Commercially, the toxin is called Botox and is used in both medical and cosmetic products. The seven primary types of botulinum toxin are A, B, C1, C2, D, E, F, and G. The FDA has authorized the usage of Botox to treat cervical dystonia.

How Can Botox Treat Cervical Dystonia?

Botox medication, a liquid solution, is administered via intramuscular injections into neck muscles for the treatment of cervical dystonia. The communication between nerves and other parts of the body is facilitated through the use of acetylcholine, a neurotransmitter and chemical messenger. Botox functions by obstructing the release of acetylcholine by the nerves, thereby preventing the transmission of messages to muscles that would otherwise cause them to contract or spasm. By weakening or temporarily paralyzing the affected muscles, Botox can alleviate the pain and discomfort caused by the involuntary contractions and spasms of the neck. 

This treatment involves injecting the toxin directly into the affected muscles, and its benefits typically last around four months (though this varies from patient to patient). These injections should only be administered by a qualified healthcare professional following a designated interval. Botox is known to provide many patients with cervical dystonia improved neck movement, reduced pain, and greater ease of conducting everyday activities. Clinical study results revealed that individuals with cervical dystonia who were treated with Botox (as opposed to a placebo group) experienced improved head posture and reduced intensity of neck pain following the treatment.

What is the Treatment Timeline?

Most individuals with cervical dystonia experience a positive response to the Botox injections, and it is common to receive these injections every 12 to 16 weeks to maintain the effects. The use of oral muscle-relaxing medications may enhance the effectiveness of the treatment or potentially reduce the dosage and frequency of botulinum toxin injections.

It is essential to note that Botox is not a permanent solution, and repeated treatments are necessary to sustain its effects. Prolonged treatment with Botox may result in the effects wearing off over time. In such cases, the body’s usual response to this treatment over time is to develop new nerve endings that resume the release of acetylcholine. 

What Risks are Associated with Botox Treatment?

Although Botox is a safe alternative to surgical procedures, there are some potential side effects that should be noted. These may include dryness of the mouth, discomfort or pain at the injection site, feelings of fatigue, headaches, neck pain, blurred vision, swelling of the eyelids, and dry eyes. Though uncommon, serious side effects of Botox treatment include serious difficulty swallowing, severe cardiac issues, and severe allergic reactions. 

Such rare events associated with the administration of Botox represent the importance of seeking out a qualified provider for this treatment. Fortunately, Dr. Matthew Kohler at Ospina Medical is highly trained in this procedure for cervical dystonia and chronic migraines. He always ensures to inject safely by using ultrasound imaging to guide the process along. Book your initial consultation with Dr. Matthew Kohler today to get started on your pain relief journey!

Written By: Maanasa Ramesh Sangeetha

Edited By: Camden Rowe