Botox for spasticity in inner thigh and hamstrings

Lyena · 05-06-2008, 08:58 PM

My physiatrist has just recommended Botox for my inner thigh muscles and my hamstrings. For the last year, my leg tone has been steadily increasing (staying bent at the knee and rolling inward). We looked everywhere for some cause (fractures, skin breakdown, soft tissue injuries) but couldn't find anything. We're both opposed to the anti-spasticity meds because they knock me out (and don't really work). Stretching has been only minimally helpful. And my willingness to just tolerate the tone is wearing out since it makes transfering a nightmare and I have a history of fracture do to osteoporosis.

I've read in old posts that Botox is recommended more for small muscles. Has anyone used it in the large muscles I'm talking about?

And is there any new data on long-term effect?

I'd prefer to avoid treating my spasticity at all but my risk/benefit ratio is shifting because of the fracture risk. Thanks so much for your input.

SCI-Nurse · 05-06-2008, 11:02 PM

I haven't heard of using it in the thigh muscles, although I do know someone who had it in their hamstrings (I guess they are a part of your thigh...) and it worked well. It seems from other posts, that people are experiencing muscle weakness from the botox in other muscles. It is hard to tell if this is more than before or is it an effect of using more of it in general. I haven't seen any thing in the literature about long term effects as of yet.
Hope that this helps.
CKF

Ian B · 05-07-2008, 01:55 AM

Hi,

A neuro suggested using Botox in the leg muscles to me a few years ago to try and counteract severely increased tone/spasticity, but was quickly discounted by another doc due to the amount of muscle groups involved and the frequency it would need to be given. Seemingly I would 'never be away from hospital' and 'my legs would end up resembling a dartboard'
They were confident it would work, but in my case the drawbacks would outweigh the benefits.

Ian

rollin64 · 05-07-2008, 01:35 PM

a neuro doc tried it on my inner thighs a few yrs back. it didn't help at all.

my physiatrist mentioned injecting my hamstrings and calves. i might give it a try since he injected my back yesterday and i'm still pain free.

SCI-Nurse · 05-07-2008, 09:34 PM

I would think that the muscles in the calvesd might have better results than the hamstrings, since they are smaller muscle groups (although still fairly large).

It doesn't hurt to try it since everyone is different- however, the larger muscle groups tend to not respond as well since you would need quite a few injections.

CKF

Lyena · 05-20-2008, 06:50 PM

Thanks so much to all of you. I think I'm going to give deep tissue massage one last chance before I resort to Botox. I just feel uncomfortable further paralyzing my already paralyzed muscles.

SCI-Nurse · 05-20-2008, 08:14 PM

Massage of leg muscles that are paralyzed is generally not recommended as if there are undiscovered clots present (DVT) this can break them off and cause a pulmonary embolus (which can be fatal).

We have had some success with Botox injections for the smaller leg muscles such as the hip adductors (the muscles that pull your legs together), but less so for the large muscles such as the gluteus or quadriceps. As with all Botox injections, it is common that treatment would need to be repeated in 4-8 months, and that for some people, repeated injections are less and less effective.

(KLD)

Lyena · 06-02-2008, 10:24 PM

KLD,

I'm sort of shocked by your post about the dangers of massage. I've had dozens of massages since I was injured and at Craig Hospital, where I did my rehab, it's part of their complementary health care program. What you're saying certainly makes sense... I'll ask my physiatrist about it.

Jenn0603 · 06-03-2008, 10:37 AM

My fiance had botox injections a few months ago in his thigh and hamstring muscles. His spasm decreased in serverity for about 2 weeks and then went right back to the way they were before the injections.

The injections are suppose to be repeated about every 6 months but I don't think he'll be going back for another round.

Imight · 06-03-2008, 02:07 PM

I get them in my inner thigh and one small shot in my right hamstring. It decreases my spasm in about a week. Lasts only about 2 months tho.

The muscle is so large that it wont paralyze the ENTIRE muscle. I am usually still about to walk and work the muscle out, its slightly weaker, but doesnt interupt.

Ive never heard of a massage being an issue, in fact they have massage therapists at sci-step and my doctor at ranch los amigos recommended it.

05-06-2008, 08:58 PM	#1
Lyena Junior Member Join Date: Apr 2003 Location: Los Angeles Posts: 23	Botox for spasticity in inner thigh and hamstrings My physiatrist has just recommended Botox for my inner thigh muscles and my hamstrings. For the last year, my leg tone has been steadily increasing (staying bent at the knee and rolling inward). We looked everywhere for some cause (fractures, skin breakdown, soft tissue injuries) but couldn't find anything. We're both opposed to the anti-spasticity meds because they knock me out (and don't really work). Stretching has been only minimally helpful. And my willingness to just tolerate the tone is wearing out since it makes transfering a nightmare and I have a history of fracture do to osteoporosis. I've read in old posts that Botox is recommended more for small muscles. Has anyone used it in the large muscles I'm talking about? And is there any new data on long-term effect? I'd prefer to avoid treating my spasticity at all but my risk/benefit ratio is shifting because of the fracture risk. Thanks so much for your input.

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05-06-2008, 11:02 PM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,349	I haven't heard of using it in the thigh muscles, although I do know someone who had it in their hamstrings (I guess they are a part of your thigh...) and it worked well. It seems from other posts, that people are experiencing muscle weakness from the botox in other muscles. It is hard to tell if this is more than before or is it an effect of using more of it in general. I haven't seen any thing in the literature about long term effects as of yet. Hope that this helps. CKF

05-07-2008, 01:55 AM	#3
Ian B Senior Member Join Date: May 2005 Location: United Kingdom Posts: 224	Hi, A neuro suggested using Botox in the leg muscles to me a few years ago to try and counteract severely increased tone/spasticity, but was quickly discounted by another doc due to the amount of muscle groups involved and the frequency it would need to be given. Seemingly I would 'never be away from hospital' and 'my legs would end up resembling a dartboard' They were confident it would work, but in my case the drawbacks would outweigh the benefits. Ian

05-07-2008, 01:35 PM	#4
rollin64 Senior Member Join Date: Apr 2005 Location: Georgia Posts: 3,405	a neuro doc tried it on my inner thighs a few yrs back. it didn't help at all. my physiatrist mentioned injecting my hamstrings and calves. i might give it a try since he injected my back yesterday and i'm still pain free.

05-07-2008, 09:34 PM	#5
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,349	I would think that the muscles in the calvesd might have better results than the hamstrings, since they are smaller muscle groups (although still fairly large). It doesn't hurt to try it since everyone is different- however, the larger muscle groups tend to not respond as well since you would need quite a few injections. CKF

05-20-2008, 06:50 PM	#6
Lyena Junior Member Join Date: Apr 2003 Location: Los Angeles Posts: 23	Thanks so much to all of you. I think I'm going to give deep tissue massage one last chance before I resort to Botox. I just feel uncomfortable further paralyzing my already paralyzed muscles.

05-20-2008, 08:14 PM	#7
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,349	Massage of leg muscles that are paralyzed is generally not recommended as if there are undiscovered clots present (DVT) this can break them off and cause a pulmonary embolus (which can be fatal). We have had some success with Botox injections for the smaller leg muscles such as the hip adductors (the muscles that pull your legs together), but less so for the large muscles such as the gluteus or quadriceps. As with all Botox injections, it is common that treatment would need to be repeated in 4-8 months, and that for some people, repeated injections are less and less effective. (KLD)

06-02-2008, 10:24 PM	#8
Lyena Junior Member Join Date: Apr 2003 Location: Los Angeles Posts: 23	KLD, I'm sort of shocked by your post about the dangers of massage. I've had dozens of massages since I was injured and at Craig Hospital, where I did my rehab, it's part of their complementary health care program. What you're saying certainly makes sense... I'll ask my physiatrist about it.

06-03-2008, 10:37 AM	#9
Jenn0603 Member Join Date: Jan 2007 Location: PA Posts: 45	My fiance had botox injections a few months ago in his thigh and hamstring muscles. His spasm decreased in serverity for about 2 weeks and then went right back to the way they were before the injections. The injections are suppose to be repeated about every 6 months but I don't think he'll be going back for another round.

06-03-2008, 02:07 PM	#10
Imight Senior Member Join Date: Nov 2007 Location: China Posts: 6,244	I get them in my inner thigh and one small shot in my right hamstring. It decreases my spasm in about a week. Lasts only about 2 months tho. The muscle is so large that it wont paralyze the ENTIRE muscle. I am usually still about to walk and work the muscle out, its slightly weaker, but doesnt interupt. Ive never heard of a massage being an issue, in fact they have massage therapists at sci-step and my doctor at ranch los amigos recommended it.