Cervical Dystonia (neck spasms)

Botulinum toxin is injected into muscles of the neck including the sternocleidomastoid, trapezius, splenious capitis and other muscles to alleviate neck spasms and pain. If not covered by insurance, this treatment cost $10 per unit. Treatment typically requires 10-20 units per injection site.

Temporomandibular Joint Pain (TMJ pain including bruxism)

The Temporomandibular joint or TMJ is a sliding hinge joint that connects your jawbone to your skull. Dysfunction in the surrounding muscles can lead to jaw pain, difficulty chewing, and a clicking and locking of the jaw joint. Botulinum toxin injection into these muscles that move the TMJ allows relaxation and alleviation of these symptoms. These muscles include the masseters and part or all of the temporalis muscles. If not covered by insurance, this treatment cost $10 per unit and typically requires 10-30 units per injection site. Both sides of the face must be treated, treating only one side will result in hyperfunctioning of the untreated side resulting in pain development. Treatment of the TMJ can also decrease bruxism or teeth grinding without the need for oral appliances.

Hyperhidrosis (excessive axillary or armpit sweating)

Hyperhidrosis is defined as sweating in excess of what is required to regulate body temperature. Primary hyperhidrosis of the armpits can be treated with periodic injections of botulinum toxin. Each armpit requires an injection of 50 units of botulinum toxin. Treatment for both armpits is $1000 if not covered by insurance. Results can last from 6-18 months.

Chronic Migraine

Chronic migraine is defined as a headache occurring on at least 15 days per month for more than 3 months with typical features of migraine on at least 8 days per month. Those features of migraine include headaches lasting between 4-72 hours with a pulsating quality, unilateral location, moderate or severe intensity and aggravation by routine physical activity. Attacks can be accompanied with nausea, vomiting, photophobia and phonophobia. It has been shown that Botulinum toxin is effective in the reduction of headache frequency and severity in patients with chronic migraine. Treatment can take between 40-200 units depending on location and severity of headaches. If not covered by insurance, treatment cost $10 per unit.

Trigger Point Pain

Myofascial pain syndrome is a common chronic pain condition that is characterized by development of distinct "trigger points” in muscle groups. These points that develop in muscles lead to pain and some relief of the pain can be achieved with injections of botulinum toxin to provide prolonged relaxation of the muscle. These injections are a combination of botulinum toxin and local anesthetic in order to provide immediate relief while the botulinum toxin takes effect. Trigger points can be a normalization of an abnormal muscle behavior. Over time these injections, when coupled with physical therapy and stretching, can “break” this abnormal muscle behavior and lead to resolution of trigger point pain. If not covered by insurance, treatment cost $10 per unit. A local anesthetic is included in this cost. Typical trigger point injection is 10-30 units per site injected.