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Physical Medicine & Rehabilitation


The practice of injecting minute quantities of Botulinum toxin, or Botox can help stroke victims regain movement and control in their arms and hands. By injecting Botulinum directly into the affected muscles, it can block the release acetylcouplecholine - a chemical that transmits the signal telling muscles to contract. Botox is especially helpful for stroke sufferers who are left with a condition called limb spasticity or dystonia. The benefit usually begins within days of the injection, peaks at approximately four weeks, and lasts three to four months.

What is spasticity
After a stroke, damage to the brain can block messages between muscles and the brain causing arm and leg muscles to cramp or spasm (spasticity), kind of like a bad charley horse. This will limit your coordination and muscle movement. This post-stroke condition makes daily activities such as bathing, eating and dressing more difficult.

Spasticity can cause long periods of strong contractions in major muscle groups, causing painful muscle spasms. These spasms can produce:

  • A tight fist
  • Bent elbow
  • Arm pressed against the chest
  • Stiff knee
  • Pointed foot
  • Stiffness in the arms, fingers or legs

What are the advantages of BT over other treatments for spasticity?

  • BT is usually effective in relaxing the muscles injected, and provides a stable effect for several months.
  • BT is preferred when only a few muscle groups are spastic, or when spasticity relief is needed in only a few muscle groups, because it allows one to treat only selected muscles.
  • BT is usually very well tolerated, in part because only very small amounts of medication go into the bloodstream.


What is Dystonia
Dystonia is a movement disorder characterized by sustained muscle contractions, usually producing twisting and repetitive movements or abnormal postures or positions. The neck is most often affected, producing cervical dystonia or torticollis. Two-thirds of patients diagnosed with torticollis improve with botulinum toxin therapy. Focal limb dystonia, such as writer’s cramp, also respond well to such treatment. Blepharospasm and hemifacial spasm are movement disorders of facial muscles that are also treated by botulinum toxin. Muscle stiffness (spasticity) from stroke or multiple sclerosis may also be relieved with botulinum toxin treatment.

How do I know If I am a good candidate for BT therapy?

BT therapy is usually considered when spasticity and dystonia needs to be relieved in only a few muscle groups. It can be used in addition to other treatments for spasticity. If your health care provider thinks that you may be a candidate for BT therapy, you will be scheduled for an evaluation. During this visit, you will also be given detailed information about the treatment, so you can make an informed decision. 

For more information or to make an appointment call, (603) 578-9363.