Recently, Botox has become a tool to help relieve migraine headaches and associated neck muscle pain. It has proven to be very effective in pain relief from muscle sources. It is important to distinguish the source of pain since Botox works on muscles. This mechanism is why Botox reduces wrinkles! Botox can be used in differentiation of pain source. If it does not give some relief, the source of pain is probably not the muscles. Many patients seeking Botox treatment for wrinkle reduction report elimination or reduction of migraine headaches as an added bonus.
In February 2011 the FDA approved use of botulinum toxin (Botox is one brand name, Dysport is another) for chronic migraine and facial pain as a primary treatment. About 40-45% of the general population suffers from head/neck/and facial pain. The administration of Botox is to relax the muscles, not to paralyze them. The botulinum toxin is a highly purified protein and there are absolutely no live bacteria in the preparation.
Botox can now be used effectively for treating bruxism (grinding of the teeth), clenching, TMJ pain, and tension type migraines. There are numerous other areas of treatment but we are limiting our discussion to muscle induced pain.
Botox treatment is a conservative treatment for orofacial muscle disorders compared to a lot of other treatment modalities. Some may work relatively well for some patients but fail to give any relief to others with tension type migraine headaches, neck pain, and other facial pains. If you have ever suffered from these types of pain, you may be familiar with dental splints/guards, physical therapy, biofeedback, oral medications or even injectable medications. There can be success with any or all of these, but there can also be failure. Botox treatment can be diagnostic too. If the same pain persists after the muscles are treated with Botox, it can be determined that the muscles treated are not the source of your pain. There are other sources of pain which should be investigated. An example of such a source could be a vascular disorder and should be addressed by an appropriate healthcare provider.
You can have tenderness and pain in a particular muscle or group of muscles or you may have referred pain from muscles away from the pain site. Some studies suggest that approximately 85% of TMJ and other facial pain disorders are muscle related. Botox affects muscles by decreasing the intensity of muscle contractions. It doesn’t mean that your muscles won’t function. It just relaxes the muscles enough to prevent extreme contractions which can cause pain.
Our masticatory (muscles we chew with) and cervical (in and around the neck and shoulder areas) muscles are integrated and so are pain pathways. Even a small area of a muscle that is injured due to trauma, chronic strain, overwork/fatigue, and inflammation can give rise to referred pain often far from that muscle. The referred pain can be referred to other muscles, joints, or even teeth. These isolated hypersensitive areas of a muscle referring pain elsewhere are known as trigger points. For example, pain in or around the ear, above the eye, or in the temple area can be referred pain from a hypersensitive neck muscle. Some upper teeth may hurt but there doesn’t seem to be a detectable “dental” problem. It could be coming from the rather large temporalis muscle. If the painful teeth are upper back teeth, the masseter muscle may be the trigger point or source of pain. The masseter muscle can also cause unexplained jaw pain. Oftentimes, Botox injected into a trigger point will eliminate the distant (referred site) pain.
The botulinum toxin Type A (Botox or Dysport) can be used effectively and safely to treat TMJ and Facial Pain. TMJ and Orofacial Pain Disorders have nearly always been treated by dentists. Just like the many other advances in technologies, materials, medicines, and protocols in dentistry, Botox is another tool to help dentists take care of their patients. Training in Botox Therapy is necessary for dentists as it is with any other health professional who would deliver this treatment.
Dr. Soberay has had training in Botox therapy (Therapeutic and Cosmetic) and continues to advance her skills with more advanced training programs.
If you have questions about whether this treatment might be an option for you, call us at 952-460-9100, or click on the link below.