StrokeSurvivorBlog

I’m sure you’ve heard of Botox injections for cosmetic reasons, but did you know it can treat neurological spastic disorders in stroke survivors?

Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and may interfere with movement, speech, and manner of walking. The degree of spasticity varies from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms.

The stroke caused spasticity in Steve’s left big toe. Excessive contractions in the long flexor muscle of the toe cause it to twitch and jerk upward hitting his shoe. This not only makes it painful, but it also pulls on the tendons in his leg. This is the biggest cause of pain in his body. It hinders his walking, and causes cramps in his leg from the arch of his foot all the way up to his thigh.

He often gets a “charley horse” in his left leg because of that toe, and he can’t wiggle his toes or stretch them out because of the weakness in his foot. Sometimes the toe really goes spastic and twitches uncontrollably for hours.

We mentioned this spasticity to Steve’s internist last week, and he suggested Botox treatments to relax the muscles. Neurology is not his area of expertise, so he said he’d call our neurologist to see what can be done. We’re not sure how Botox injections will affect Steve’s walking, but if it can relieve the pain, that would be wonderful. Next week when he sees his neurologist, we hope to find out.

A number of studies have demonstrated that Botox (botulinum toxin type A) decreases muscle rigidity in spastic muscles by temporarily blocking the nerve cells from sending impulses to the muscles.

Botox was originally used to treat disabling neurological diseases, and in 1989 the U.S. Food and Drug Administration approved Botox therapy for the treatment of crossed eyes and uncontrollable blinking. In fact, more Botox treatments are used for neurological muscle disorders than for cosmetic reasons, so we are hopeful that this will help Steve.

According to the American Stroke Association, 780,000 Americans suffer a stroke each year. With spasticity affecting anywhere between 15% to 30% of stroke survivors, at the low end, that calculates to 115,000 Americans a year who could experience spasticity of some degree. But the FDA has not yet approved Botox therapy for treatment of spasticity, so it is not widely known that this can help. It remains as an off-label use. Despite the lack of the government’s approval seal, the treatment has become mainstream, and the Academy of Neurology has endorsed it as a first line treatment.

Because of the lack of FDA approval for this use, some insurances may not cover it. However, I read somewhere that Medicare will pay for this type of treatment. Botox injections will be required about every 3 months for continual relief, and that can be very expensive if not covered by insurance. So my prayer is that it will be covered and that it will be effective in helping Steve. I will keep you updated on his progress with this, and I’d appreciate your prayers as well.