Botox Injection in Neck for Fibromyalgia: Now Have Extreme Side Effects

In one week I got muscle pains in the back of my neck. I could tolerate this but it got worse and actually moved down my neck to both shoulders and fineally moved to the muscles at the surface of my left sholder. If I lay down and completly relax it goes away. I work on a computer and after a bit everything comes back. It is many times worse than the fibromylgia. It is very bad muscle pain an actual burning pain and numbness. What can I do or do I just have to wait for the botox to wear off?

Doctor Answers 7

Botox for muscles off the face

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Once muscles are treated off the face, more units are usually needed. Sometimes treating one muscle may cause an adjacent muscle to overcompensate and this can throw off the balance of your musculoskeletal strength and posture. The nontreated overactive muscles may start to spasm. Rather than injecting Botox in those muscles, maybe having massage or even seeing a pain management doctor can provide relief or through physical therapy.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox Injection in Neck for Fibromyalgia: Now Have Extreme Side Effects

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what you are experiencing is the law of unintended consequences. this happens all the time with botox injections, sometimes with actually good results, sometimes with poor results. the platysma muscle in the front of the neck is a depressor (it lowers the jaw) as opposed to the muscles in the back of the neck which are elevators of the head (allow you to look up). when the posterior neck muscles were injected the balance bewtween depressor and elevator was upset leading to other muscles  trying to do jobs they are not well positioned to do, leading to all sorts of muscular mayhem.  part of me wants to try to balance the muscle function with further injections, luckily the smarter part of me will prevail and recommend you ride it out and consider wearing a soft collar to help relax the muscles that are overworking. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Botox for Fibromyalgia

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Botulinum toxin (BTX)  or Botox injection is being increasingly used 'off label' in the management of chronic pain. Data support the hypothesis of a direct analgesic effect of BTX, different to that exerted on muscle. Although the pain-reducing effect of BTX is mainly due to its ability to block acetylcholine release at the synapse, other effects on the nervous system are also thought to be involved. BTX affects cholinergic transmission in both the somatic and the autonomic nervous systems. Proposed mechanisms of action of BTX for pain relief of trigger points, muscular spasms, fibromyalgia and myofascial pain include direct action on muscle and indirect effects via action at the neuromuscular junction. Invitro and invivo data have shown that BTX has specific antinociceptive activity relating to its effects on inflammation, axonal transport, ganglion inhibition, and spinal and suprasegmental level inhibition.
The mechanisms of action, efficacy, administration techniques and therapeutic dosage of BTX for the management of chronic pain in a variety of conditions shows that although muscular tone and movement disorders remain the most important therapeutic applications for BTX, research suggests that BTX can also provide benefits related to effects on cholinergic control of the vascular system, autonomic function, and cholinergic control of nociceptive and antinociceptive systems. Furthermore, it appears that BTX may influence the peripheral and central nervous systems. The therapeutic potential of BTX depends mainly on the ability to deliver the toxin to the target structures, cholinergic or otherwise. Evidence suggests that BTX can be administered at standard dosages in pain disorders, where the objective is alteration of muscle tone. For conditions requiring an analgesic effect, the optimal therapeutic dosage of BTX remains to be defined.  I first introduced the use Botox® for pain around 2000. The use of Botox ®(Botulinum toxin type A) treatment for fibromyalgia reduces both pain and muscle spasm. If a patient has frequent spasms and pain, then Botox® is a superb treatment
Botox works by effectively relaxing muscles as well as decreasing the messages transmitted through pain receptors. Which means that the sensation of pain is greatly reduced. . After injection the pain relief usually occurs within 7 days. The levels of pain relief experienced by patients varies, according to the severity of their condition etc., but it is usual for patients to feel significant levels of pain reduction for up to 4 months. So although it is not a permanent means of controlling pain, it is effective as a long-term way of pain
Management and by seeing patients every 4-6 months the can essentially remain pain free. The procedure is very safe due to the fact that one should use onlysmall doses of Botox® . There are significant risks associated with Botox but only in unskilled hands usually in large doses in Children. In some cases, where there is an underlying medical condition other than fibromyalgia such as Myasthenia Gravis where Botox cannot be used. Botox is quite amazing when dealing with pain and muscle spasms that you may have. It cannot deal with any other symptoms. However the pain relief can really enhance your life!  Arnold Klein

Arnold W. Klein, MD (in memoriam)
Beverly Hills Dermatologic Surgeon

Botox for Fibromyalgia, Now Side Effects

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Hi Cyberdan,

You should contact your injecting physician for follow up and advice.  Most likely the best course will be to allow the Botox to wear off.


Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Pain after Botox

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In 10 years of using a lot of Botox I have only seen on mild one day headache.  You need to go back to your doctor.  I believe this is something other than Botox.  Dr George Commons

Very few doctors on this forum do these types of treatments.

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Cosmetic BOTOX and dysport treatments involve very small doses of these drugs and are not associated with much in the way of systemic side effects.  This is very different for the type of injections you received with much higher doses of botulinum toxin.  With higher doses, systemic side effects are much more common.  Your best course is to immediately contact your treating physician and let them know about what is going on.  They may have specific recommendations for your current side effects and also you need to discuss with them what should be done from here.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Pain after neck Botox

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It sounds like just waiting until the Botox wears off would be an option.  You could also try to exercise the neck and shoulder muscles, under your physicians approval, as a means of making the Botox wear off more quickly.  Best to ask the MD that did your Botox injections in the neck.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 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.