Is Botox an effective treatment for spasticity after stroke?

Following a stroke, miscommunication between the brain and muscles can cause the muscles to involuntarily contract and become stiff, a condition known as spasticity. One way to relax the muscles is to use Botox for stroke patients.

Most patients aren’t told exactly how Botox works, so they only see short-term results. This article will show you how to turn your temporary gains from Botox into lasting relief.

Botox for Spasticity After Stroke

Spasticity is a condition where the muscles become stiff due to prolonged muscle contraction after neurological injuries like stroke. Patients may feel like spasticity is a problem with the muscles, but the problem stems from miscommunication between the brain and the muscles.

When a stroke damages the motor cortex, it impairs the brain’s ability to tell the muscles to either contract or relax. This miscommunication can cause multiple muscles to contract at once without being able to relax, causing spasticity.

By injecting Botox directly into the muscles that are affected, spasticity can be significantly reduced. Botox (botulinum toxin A) works as a “nerve block” that blocks the release of chemicals that signal your muscles to tighten. As a result, your muscles relax.

This study found that reduction in spasticity was associated with significant improvement in arm function after stroke. It suggests that a moderate dose of Botox helps reduce spasticity long enough to allow for functional improvements without causing a significant decrease in strength.

However, it’s important to understand that Botox is not a permanent fix. Because it does not address the underlying cause of spasticity, Botox only provides temporary results. Once injected, its effects generally last about 3-6 months. Unless you get another injection, spasticity will return. 

By taking advantage of the reduced muscle tone while using Botox and focusing on the root cause of spasticity (restoring the brain-muscle connection), individuals can achieve long-term spasticity relief.

In the following section, we’ll address some side effects associated with Botox.

Side Effects of Botox for Stroke Patients

While Botox can be an effective form of spasticity treatment for stroke survivors, there are potential side effects you should be aware of.

Common side effects of Botox include:

• Soreness
• Fatigue
• Nausea
• Muscle weakness
• Headache
• Bruising
• Joint pain

While general soreness and bruising near the injection site are normal, more serious complications like muscle weakness, difficulties breathing, vision problems, and loss of bladder control warrants immediate medical attention. Call your doctor if you experience these complications after your Botox injection.

In the following section, we’ll discuss how to take advantage of Botox to promote more permanent relief.

How to Maximize the Benefits of Botox for Stroke Patients

Botox becomes a temporary treatment when you don’t use it in conjunction with physical therapy to restore your brain-muscle communication.

It’s kind of like using pain killers for a broken ankle without wearing a cast. The painkillers will make the pain go away, but you aren’t doing anything to heal the root problem.

That’s why it’s important to treat spasticity on both levels: relieve the symptoms temporarily with Botox and cure the root cause long-term by doing rehab exercises.

Using Botox without participating in physical and/or occupational therapy will make the treatment temporary. But if you use the effects of Botox to create an opportunity to exercise, then you can see long-term results.

Recovery after stroke is possible because the brain is can utilize neuroplasticity. Neuroplasticity is the central nervous system’s ability to reorganize itself based on your behaviors. Consistently practicing movements affected by stroke will help promote rewiring of those functions to healthy, undamaged regions of the brain. As a result, those movements will no longer be affected by spasticity.

Botox loosens your muscles so that you can move in the short term, and rehab exercise will reinforce demand and promote neuroadaptive changes in the brain so that you can keep moving in the long term.

Alternative Treatments to Botox for Stroke Patients

Although many individuals experience spasticity after stroke, only some may benefit from Botox while others should consider alternative options. Other spasticity treatments include electrical stimulation or medication such as Baclofen, which can help treat muscle stiffness and spasticity. Both of these spasticity treatments work best when combined with rehabilitation exercise.

Baclofen can be taken orally, or it can be surgically implanted through an intrathecal baclofen pump. Although medication can be helpful, it’s important to consult with your doctor before taking any because there may be potential side effects that can interfere with your recovery.

Electrical stimulation works by placing non-invasive electrodes on your skin and sending gentle electrical impulses to your affected muscles. This stimulation helps the muscles contract and promote communication with the brain. It might seem counterintuitive for someone with spasticity to use a treatment that helps the muscles contract even more.

However, the stimulation helps engage neuroplasticity and, when combined with rehabilitation exercise, will help spastic muscles loosen over the long-term. Be sure not to use electrical stimulation if you have a pacemaker, and always consult with your doctor before trying any new treatments for spasticity to ensure it is safe for you.

Using at-Home Therapy to Reduce Spasticity Long-Term

Whether you use Botox, medication, or electrical stimulation, it’s essential to keep rehabilitation exercise as a staple of your regimen. Many survivors stay engaged in rehabilitation exercise during their therapy sessions, but they usually attend just 1-2 therapy sessions per week. This is not enough to keep neuroplasticity consistently stimulated, and therefore it’s important to stay engaged in therapy exercises at home between therapy sessions.

Many therapists provide survivors with written sheets of exercises to follow at home between visits, but it can be tough to stay motivated to do them daily. This is where you can use high-tech home therapy devices like FitMi from Flint Rehab to keep yourself motivated. This interactive device helps you accomplish high repetition of therapeutic exercises by turning it into an interactive game.

If spasticity causes too much muscle tightness to exercise, you can consider using Botox to provide short-term relief and use FitMi to activate neuroplasticity for long-term mobility.

Here’s a story from a survivor that used a combination of treatments to reduce spasticity after stroke:

 “Cliff had his stroke in May 2019 which left him with aphasia and right sided weakness in his right leg and right arm and unable to use his right hand. He also has spasticity in his hand which causes his thumb to go inwards. Although through physio and Botox he has gained a little movement in his hand, we ordered the FitMi. 

Cliff started using it right away managing only a short time at first and some of the exercises he couldn’t do. Gradually over the last few weeks he has built up to doing 40 mins a day and yesterday managed to actually do 3 thumb press and releases which he hasn’t previously been able to do. There are still some exercises that Cliff cannot do or can only manage a few but everyday I can see an improvement not only physically but also in his mental well being. He is so determined to beat his high score and it’s really encouraging him to keep trying. He is really enjoying using the FitMi and we really recommend it.”

-Susan T.

Rehab exercises after Botox are key to reduce spasticity and improve overall mobility long-term. Whether you use FitMi or follow along to written sheets of exercises, what matters is that you achieve high repetition to keep neuroplasticity activated.

Botox for Stroke Patients: Key Points

If you’re experiencing spasticity after a stroke, Botox may be an effective solution. However, it’s essential that you take advantage of its muscle-relaxing effects and participate in intensive rehabilitative therapies to promote long-term spasticity relief. Without addressing the underlying cause of spasticity, individuals will only experience short-term relief.

We hope this article helped you better understand what Botox is and how to use it to effectively treat spasticity.

The post Botox for Stroke Patients: How It Can Help with Spasticity Relief appeared first on Flint Rehab.