As coveted as it is for its ability to slow the advance of those wrinkles that start appearing in middle age, Botox was not always used in fulfilling our superficial desires. First approved for use in the US in 1989, the product was originally intended to treat muscle spasms of the eye and face. Since its introduction, its popularity for cosmetic treatment has swelled to the levels we now know, overshadowing its standard medical uses. However as a powerful nerve toxin, the medication still serves numerous "real" medical purposes. One such very important use for Botox or Botulinum toxin is in the treatment of pain.
Botulinum toxin, the scientific name for Botox, is a by-product of a type of bacteria found on spoiled meat. The toxin is one of the most potent nerve toxins that exist making it deadly in all but the smallest of doses. However, in such extremely low doses, the effect of the toxin in the body is to temporarily inhibit the transmission of nerve pulses. This effect is what allows the toxin to stop wrinkles because it limits the ability of the nerves to tell our muscles to contract, which would normally cause wrinkles.
The effect of botulinum toxin in inhibiting nerve pulses is very important in the field of pain management for several significant reasons. One reason is that not all forms of pain are equivalent and some types of pain do not respond well to standard analgesics or painkillers. Thus, for some of these types of pain, the toxin offers relief where other forms of medication cannot.
A second reason for the importance of the toxin in managing pain is because the toxin has relatively long duration effects on the nerves that are exposed to it. Those who use Botox for cosmetic purposes will know that the effects of an injection last for several months. For the control of pain, this means that injections of the botulinum toxin can be used to prevent pain in certain conditions where pain is chronic or sporadic in nature. At the same time, the long duration effects in limiting nerve function also avoid the risks of addiction that can come with use of many other forms of painkiller.
Because of these specific benefits, the use of botulinum toxin in pain management continues to grow. One example of the use of the toxin is in the treatment of a condition called Thoracic Outlet Syndrome (TOS); a condition that as much as 8% of the population might experience. The condition is caused by compression of some nerves in the lower neck that occurs because the ducting containing the nerves is smaller than it should be. For those who suffer Thoracic Outlet Syndrome, numbness, muscle weakness and feelings of extreme pain
When researchers from Johns Hopkins University gave a number of TOS patients a series of botulinum injections, the scientists observed that even after 2 months following the injections, the pain levels experienced by the patients were 29% lower than in those who did not receive the injections. In this case, the toxin provided a significant means for pain prevention. That said, future research is still required to determine how long such treatment can be continued.
In another example of the use of botulinum toxin to control pain, independent researcher efforts at King's College London and Sheffield Hallam University have used the treatment for those with overactive bladders. In their research, they found that treating the bladder lining with botulinum toxin achieved an 80% success rate in stopping the frequent need to urinate
and the pain associated with such conditions. With approximately 1 in 6 people suffering from overactive bladder issues, the treatment has potential to reduce the need for pain medication in a significant portion of the population.
For those who have suffered a stroke, the use of botulinum toxin is also showing benefits in the control of pain. Among those who suffer a stroke, almost 60% experience muscle spasms and the significant pain that accompanies them. To combat these symptoms, roughly half of such patients normally take medications that leave them mentally confused, sedated and weak. Unfortunately, this interferes with their ability to recover following the stroke
As an alternative, researchers at Wake Forest University used botulinum toxin to inject the hands, wrists and elbows of those who were suffering from muscle spasms. The researchers observed a "significant reduction" in the level of pain experienced by the patients. Given the aging population and the more than 800,000 Americans, 150,000 Britains and 60,000 Australians who experience strokes each year, the use of botulinum toxin as alternative to other pain management drugs is significant.
Keeping along the same theme of conditions that affect us as we age, Parkinson's Disease is another condition with pain complications that is being treated with botulinum toxin. With similar problems of rigid muscles and muscle spasms caused by the condition, the use of the toxin reduces the pain of those suffering from the condition. At the same time, because of its longer duration effects, it reduces the need for other pain medications that patients with Parkinson's Disease often require
In the most recent news, botulinum toxin is now being used for the prevention of chronic migraine headaches
. The US Food and Drug Association (FDA) approved it in the fall of last year and the UK Medicines and Healthcare products Regulatory Agency (MHRA) did so last summer. This makes the treatment widely available for the roughly 1 in 100 people who suffer from this form of chronic pain
. With these individuals suffering the effects of such headaches for more than 2 weeks each month, the treatment offers hope to reduce the debilitating effects experienced by these migraine sufferers.
Although Botox has earned celebrity status for its more superficial benefits in keeping us looking young, the botulinum toxin does have significant benefits in the field of pain management. With the treatment of chronic and sporadic pain often requiring the ongoing use of powerful painkillers, the use of this toxin offers an important alternative that so far shows limited negative effects. As a result, for those suffering from chronic pain, botulinum treatment is worthy of discussion with one's physician.
Though the negative effects of botulinum toxin on the body are minimal, it does have effects and a future article will cover what scientific research has discovered so far. If you suffer from chronic pain, consider sharing your experiences in the health forums