Have you heard of Botox ® for neck pain? – Health Care News San Antonio

Do you suffer from painful spasm of your neck muscles?

Does your head or neck tilt to one side?

You may be suffering from Cervical Dystonia.

Cervical dystonia, also called spasmodic torticollis, is a painful condition in which the muscles in your neck contract involuntarily, causing your head to twist or turn to one side. The abnormal muscle contraction can also cause the head to uncontrollably tilt forward or backward.  Often times, the abnormal head turning may also be associated with head shaking or tremor.  Most people with cervical dystonia experience excruciating neck pain that can radiate to shoulders. It can also cause, precipitate, or worsen headaches.  In some patients, the pain from cervical dystonia can be exhausting and disabling.

So what causes cervical dystonia?

Cervical dystonia is actually a rare disorder that can occur at any age, even infancy.  Most often, cervical dystonia occurs in middle-aged people, where women are more affected than men. Symptoms generally begin gradually and then reach a point where they don’t get substantially worse.  In most cases of cervical dystonia, we don’t know why some people develop the disorder and others don’t. Some cases, however, appear to be linked to: head, neck or shoulder injuries, head, neck and other spinal diseases, and certain drugs notably specific antipsychotic or anti-nausea medications.

Some risk factors for cervical dystonia have also been identified and these include:

• · Age; while the disorder can occur in people of any age, even children, it most commonly begins between the ages of 40 and 70.

• · Sex, compared with men, women are nearly twice as likely to develop cervical dystonia.

• · Family history, if a close family member has cervical dystonia or some other type of dystonia, then that individual may be at higher risk of developing the disorder.

Some people who start out with cervical dystonia eventually develop similar symptoms in neighboring regions, such as the shoulder or face. However, cervical dystonia in middle age does not expand to wide areas of the body, as may occur in children.  The disability and pain that can be caused by cervical dystonia may result in depression.

 What are the treatment options?

There is no cure for cervical dystonia. The disorder sometimes resolves without treatment, but sustained remissions are uncommon. Based on expert opinion, the most effective treatment option for cervical dystonia is injecting botulinum toxin (most people know it as Botox ®) into the affected muscles.  There are currently four brands of botulinum toxin approved by Food and Drug Administration for the treatment of cervical dystonia namely Botox ®, Myobloc ®, Dysport ®, and Xeomin ®.  When botulinum toxin is injected into affected muscles, it often reduces the abnormal head posturing and pain associated with the disease. The result usually take effect as early as 3 days and may last up to 4 months, thought the average treatment period is every 3 months or 12 weeks

Oral medications may also be used to treat the abnormal head posturing and painful muscle spasm.  However, the frequent side effects of some of the medications such as dry mouth, constipation, memory problems, reduced urinary stream or visual blurring make them less favorable.  Muscle relaxants often help a little by relaxing the tight and tense muscles, but also have side effects, most notably sedation, imbalance and mild cognitive impairment. Examples of these types of drugs are diazepam (Valium, Diastat), lorazepam (Ativan), clonazepam (Klonopin) and baclofen (Lioresal).  In rare and refractory cases, surgical interventions may also be considered.

Are there other approaches to ease symptoms of cervical dystonia?

• Exercises that improve neck strength and flexibility

• Judicious use of a neck brace

• Training in stress management techniques

• Support groups

Health Care News San Antonio – Helpful Links:

LINK TO Health Care Experts Page

Link to Dr. Vicki Alvarez’s Experts Page

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All the best,

Vikki Alvarez, MD

Adult Neurology with Sub-specialty in Movement Disorders

Diplomate, American Board of Psychiatry and Neurology
Center for Neurological Care and Research
9150 Huebner RD., Suite 160
San Antonio, TX, 78240
Office (210)579 0709
Fax    (210) 579 0748
www.CNCR.biz

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