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Multiple Sclerosis Spasticity: Could Botox Help?

Myelin assaults by the immune system cause multiple sclerosis. Myelin sheath degeneration can induce nerve dysfunction and bladder, arm, leg, and trunk spasticity.

Myelin assaults by the immune system cause multiple sclerosis. Myelin sheath degeneration can induce nerve dysfunction and bladder, arm, leg, and trunk spasticity.

Is it possible that this infamous cosmetic treatment could actually help your multiple sclerosis? Maybe, actually. Let me explain.

Treatment for multiple sclerosis (MS) can include a variety of approaches, each tailored to the individual patient based on their symptoms and their way of life. Relapses, symptoms, and the progression of MS can all be mitigated by using disease-modifying therapies (DMTs), which work by dampening the immune system activity that characterizes the disease. Muscle spasticity and urinary retention are two symptoms that Botox (onabotulinumtoxin A) may be able to alleviate.

Botox is a neurotoxin that can be injected to relax muscles in the forehead and reduce the appearance of frown lines and other facial wrinkles. However, it is also put to medical use, notably in the treatment of migraines and the control of excessive perspiration.

When treating multiple sclerosis (MS), Botox can be helpful for treating muscle spasticity, which refers to the involuntary contraction of a muscle. This includes bladder spasticity. The following information is necessary for you to be aware of if you are thinking about getting Botox treatment for multiple sclerosis.

In multiple sclerosis, what exactly is spasticity?

In multiple sclerosis, the immune system mistakenly targets the myelin sheath, which insulates and cushions the nerves. Myelin sheath degeneration causes nerves to malfunction, which can lead to spasticity in the muscles of the trunk, arms, legs, and bladder. 

Most people with multiple sclerosis also experience spasticity in their limbs and problems controlling their bladders; Botox is just one treatment option for these symptoms. Given the difficulty of addressing these symptoms, it is helpful to have as many options for treatment as possible.

Botox Treatment for Multiple Sclerosis

Botox is typically used to treat urinary incontinence and muscle spasms, both of which are common symptoms of multiple sclerosis. According to the National Multiple Sclerosis Society, approximately 80% of people with MS experience bladder symptoms, which can have serious psychological consequences such as aversion to liquids, reluctance to participate in social situations or physical activity, worry about incontinence during intimate moments, disturbed sleep, increased tiredness, and shame.

A study published in Current Neurology and Neuroscience Reports reports that the prevalence of spasticity in MS patients ranges from 60% to 84%. Spasticity manifests itself in a wide variety of ways, from a generalized sense of stiffness to specific areas of the body (most commonly the legs) experiencing involuntary muscle spasms that can become so painful that they limit movement. Muscles can become so rigid that it’s hard to move your limbs.

Botox has been proven useful for treating bladder issues and spasticity by inhibiting acetylcholine, which causes muscle spasms.

Botox has been proven useful for treating bladder issues and spasticity by inhibiting acetylcholine, which causes muscle spasms.

Muscle spasms can be treated with Botox by blocking acetylcholine, which has been shown to be effective for bladder problems and spasticity. According to a meta-analysis of 18 studies, 42%-87% of people who received Botox for overactive bladder reported that it had completely eliminated their incontinence issues. Recent research has not been able to quantify the benefits of Botox for MS spasticity, but it has been found that nearly 90% of participants are still receiving injections three years after starting treatment.

As an example, if leg muscle spasticity is significantly reduced over the course of three to four months, this can improve the efficacy of physical and occupational therapy and lead to better sleep, all of which have positive effects on the patient’s mood, energy, inflammation levels, and immune function. Anxiety relief, increased social activity, boosted confidence in day-to-day situations, and improved sleep quality are all potential side effects of treating bladder dysfunction.

Botox would likely be prescribed alongside other treatments and potential lifestyle adjustments. Botox isn’t something we’d do first if other methods, like medication, have failed, but it can be a helpful option if necessary. DMTs are the standard treatment for multiple sclerosis.

How Things Are Done

The clinical application of Botox will vary depending on the symptom being treated and the expertise of the physician administering the injection. A neurologist may refer you to a urologist who can administer Botox for bladder dysfunction, but they’re the ones who’ll handle limb muscle spasticity.

A muscle-specific injection is used to treat spasticity in the limbs. Electrical signals are sent through the needle to contract the muscle and ensure an accurate injection. Your doctor will know which muscle to inject Botox into based on how much it contracts. A study published in the Journal of Neurology, Neurosurgery, and Psychology found that spastic muscles contracted significantly less than relaxed muscles.

When dealing with bladder dysfunction, things get a little more complicated, but they don’t take long at all. The procedure is as follows:

  1. You will have a catheter inserted into your bladder and a local anesthetic like lidocaine will be injected into the bladder lining to numb it.
  2. After waiting around for half an hour, the urethra is opened and a small scope with a camera on the end (called a cystoscope) is inserted into the bladder..
  3. By inserting a thin needle through the scope, Botox solution is injected into the bladder muscle. 

It is possible to numb the bladder and perform the injection itself in under an hour, meaning that the entire process can be completed in under thirty minutes.

A patient may benefit from your help if you have the appropriate education and experience to do so. Dentox can help you get the best training possible so that you can give your patients the best care possible and expand your business. Dr. Howard Katz is widely regarded as one of the best injectable trainers in the United States. 

He provides his students with a variety of learning options, including in-person, online, and on-demand lessons. You can find online courses at and live courses with actual patients at

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