Can Botox Treat Back Pain?

Can one of America's most popular cosmetic treatments provide powerful relief for chronic back pain? Many doctors and patients say, "yes." Here's what you need to know about back pain, Botox, and the beauty of pain relief.

Botox is a trade name for Botulinum Toxin A; a powerful neurotoxic protein produced by the bacterium Clostridium botulinum. In large doses, botulinum Toxin A causes botulism, a rare, potentially life-threatening paralytic disease associated with food poisoning. In controlled medical doses, however, diluted Botox causes a mild paralytic or relaxing effect on muscles. It is most commonly used to decrease muscle contractions in the face and reduce the appearance of wrinkles. Botox is also used to treat a variety of non-cosmetic health problems, including overactive bladder problems, extreme sweating, migraines, chronic pain, neuralgias and more. Now, it's being used to treat chronic low back pain associated with muscle spasms.

How It Works

Doctors administer Botox in a series of injections into muscle tissue to block nerve impulses that cause muscles to contract. This might be appropriate for select patients whose chronic back pain is due to muscle spasms that are unrelieved by physical therapy, massage, exercise or other treatments. Botox can provide several months of relief and some reports say it significantly reduces pain.

The downside of using Botox is that it has not been studied for off-label uses, including back pain relief; however, clinical trials are being conducted. Botox is a known poison and while it is currently considered safe for certain uses, the U.S. Food and Drug Administration (FDA) has not approved it for back pain relief. Long term effects of receiving multiple doses of botulinum Toxin A have not been established. Injections may have to be repeated every few months once the muscle-relaxing effect subsides. Botox injections are expensive, and some insurance companies may not cover it.   

Could Botox Work for You?

First, your doctor must determine that your pain is muscle related. Patients with arthritis, spinal injury, and pain caused by bone or nerve damage are not considered good candidates to receive Botox injections. Traditional treatments like exercise, massage, and physical therapy are usually enough to relieve muscle spasms in most patients. Some patients' pain is relieved with pain medication (nonsteroidal anti-inflammatory medications and/or narcotic pain medications) and others just need time for healing. Less invasive health care practices including chiropractic and acupuncture may also be effective. 

If you've tried everything else, however, Botox injections might be the right treatment to break your pain cycle. Get advice from a doctor who specializes in pain management. 


Current Clinical Trial for: Botulinum Toxin A for the Treatment of Chronic Lumbar Back Pain