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Question About Botox for Illness?

I have Blepharospasm and have to have injections of botox every 3 months to be able to open my eyes. Yesterday was the first time in 13 years that the shots were unbearable and painful. It was not the needle...it was the botox...it burned like fire as it went in. These were all around my eyes and around my TMJ muscle. There HAD to be something different yesterday than all of my previous injections...it totally wiped me out, it hurt so badly...and I take a pain pill before having the shots.

Doctor Answers (5)

Botox injection and pain - saline or sterile water

+1

Botox reconstituted with saline is not painful upon injection whereas Botox reconstituted with sterile water is painful upon injection.


Buffalo General Surgeon
4.5 out of 5 stars 7 reviews

Pain from botox

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you should ask your doctor if the botox was mixed with a different type of saline solution than usual (preserved or non preserved) or with water or anesthetic or anything else. Possibly some of the botox was injected in a vessel inadvertently.This is not a fault of the physician but can happen as the vessels are underneath the skin and not visualized necessarily.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

If Botox burns it is possible it was reconstituted with sterile water.

+1

Generally BOTOX is reconstituted with injectable saline not water.  The sterile water for injection is hypotonic-meaning that it contains far fewer constituents that the fluid in the tissue.  Injecting such a solution causes salts from the tissues to be drawn into the dilute solution.  These shifts in salts and fluids cause discomfort.  Occasionally, it is possible to have an injection actual bruise a sensory nerve and this can also be quite uncomfortable. I would let your doctor know about your discomfort.  Unfortunately, sometimes doctors who do functional BOTOX injections dismiss the treatment discomfort.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 18 reviews

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Botox pain

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What you are describing is highly unusual as you know having had experienced Botox in the past. Typcially it is mild discomfort for the short second or two that the injection is being performed. I would suggest you discuss with your surgeon to see if anything has changed.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Different Diluent

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One possible explanation is perhaps, the physician or medical assistant used the wrong diluent when Botox was being re-constituted. Botox comes as a film around the vial and a diluent is added to it. Perhaps, Sodium Bicarbonate was added, or a numbing agent, that may have burned and stung. For some crazy reason, for which I have not found an explanation, there is a national shortage of Xylocaine ( Lidocaine) and we physicians  are forced to use a different numbing agent than Xylocaine. Not that we use a numbing agent for Botox, but perhaps, this was inadvertently used by a medical assistant instead of saline. 

I am not a neurologist,but it would seem that this is not a nerve issue since you describe pain in various areas, affecting different nerves.

I would suggest that next time, your physician perform a small test dose, before proceeding with the treatment. 

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.5 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.