Anyone had Botox for shoulder pain?

[StripeyMoon]

After several different treatments for chronic neck and shoulder pain I am left with this option or longer term anti depressants to relax the muscles. I really dont want to take the drugs but also don't want to have the botox if it's not going to achieve anything except an even more sore shoulder!

I've never heard of botox as a treatment for pain but am very interested to find out about it, DH is suffering chronic shoulder pain and is finally having a scan in a fortnight, it's only taken 12 weeks .

What other treatments have you had and what is your diagnosis?

Well, its a bit long term, I had a car crash when I was 18 which left me with torn shoulder muscles and a bulging disc in my neck. The sholder never realy healed properly and has caused me problems over the years but since having my children it has definately got worse. Stress definately makes it worse to the point of being unable to function and just wanting to cry all the time (through frustration more than pain IYKWIM).

Anyway, last Sept my mum was taken seriously ill and was hospitalised for several months and of course shoulder kicks off again. Luckily I get BUPA through work so got the GP to refer me to physio (again) and he thought the pain was geting worse due to joint degeneration in my neck. Physio was not helping but making it worse so got referral to Pain Consultant. He tried ADs which didn't work and progressed to steriod injections in the neck joints and upper thorasic and into the superscapular muscle. Neck pain eased after about 6 weeks but shoulder is still awful. GP did an MRI which showed nothing more than a bit of deterioration to C6/7 and pain consultant gave more ADs - still didn't work.

Basically he thinks that the muscle is incredibly overactive (most likely due to damage done earlier)and is pulling at the ceck and trapping the nerve into the superscapular muscle casuing pain to the whole area. Botox treatment apparently immobilises the muscle and then, in theory, it doesn't hurt anymore.

So basically, they don't really know why I am in so much pain but I put it dow to the accident, crap posture, two big breastfed babies and a stressful life - oh and getting older and more worn out in general!

How did you DH hurt himself?

Apologies for all the typos!

One of DS's classmates is having this. (He is only 6) He has very limited mobility and is in a wheelchair. I can ask his mum about it if you like and report back.

Yes please Hobgoblin, how awful for that poor little boy to go through that at 6 .

That sounds awful Stripey . I suppose the botox has to be worth a try.

DH hasn't hurt himself ( that he can remember), that's the weird thing, he's had pain for over a year now, first he had 6 months of physio, which gave him full mobility but didn't ease the pain, 12 weeks ago he had x-rays and he's now finally got an appt for an ultrasound scan, they say it could be an impingement or a rotator cuff tear but his constant symptoms don't really seem to fit either from what I've read, it doesn't matter if he rests it or uses it, the pain is always there, driving seems to worsen it and he drives almost 100 miles a day to and from work.
Painkillers have almost no effect and he even paid out a small fortune to have intensive chiro treatment when he was off sick for a fortnight, it seemed to help at first but now he thinks it was simply the fact that he felt like something was actually being done and the chiro was convinced it would sort him out.
My worst fear is that they won't find anything on the scan and he will continue on pain, he's absolutely had enough now because the pain never goes away.
I've got my fingers crossed that he will be fixed by CS injection or at worst case scenario, keyhole surgery, we're both just so angry that it's taking so long just for a diagnosis.

In your case, I thought that ADs were given for nerve pain, which doesn't respond well to normal painkillers?

I hope you get some respite from the pain very soon, it's a miserable existence to be in constant pain, DH has even stepped down from his stressful and demanding job into something less so, he no longer has the patience or level of concentration needed and luckily his employers have been good enough to accomodate him, he can't carry on like this though, he feels like a failure.

I will ask as soon as I see her or send her a FB message and let you know. Very sad for him as he has a twin brother who is not disabled in any way which probably makes his lot a little harder to take. I don't know, I don't know what it feels like to be disabled and think it may be too easy to assume it is miserable. He is a very friendly and happy little boy with many friends and lots of support.

I guess as you get older it becomes difficult as children aren't so kind as a rule the older they get.

Anyway, I digress...

Malificence, he probably needs an MRI rather than an ultrasound because it will show up everything including trapped nerves. Is he getting any numbness in his arm, especially when driving? Pain killers having no effect is often a sign of nerve problems rather than an injury (apparently), I also had no relief from pain killers, even prescribed ones.

My painconsultant suspected trapped nerves early but my MRI didn't show any in my neck(although a lot of my symptoms regarding the neck pain and headaches would suggest it). He definately said the ADs were to relax the muscles though.

I also go to a chriopractor once a month and I love her! She is much better than the physio and gives me some relief but she uses Mctimmoney rather than the bone cruncher type of chiropracty!

Not finding anything on my scan was both a blessing and a huge disappointment. I was glad that there was no damage to be worried about but also upset in that we were no closer to finding out why I am in pain.

I know exactly how your husband feels, worst of all is that no-one can see it and so its hard to get empathy and also people get tired of you moaning about it (in fact you get tired of hearing yourself moan about it!). I have resigned from my job also and am leaving at the end of the month. This job is very stressful and I think it is making the pain worse.

If I go ahead with the botox I will let you know the outcome. In the meantime hope your husband gets some help from the medics.

Thanks Hobgoblin, you are right, we do make judgements easily. I hope he maintains such a positive outlook.

The only real benefit from the chiro was that it removed the pins and needles/numbness in his fingers, he said there was a compressed vertabrae in his neck - he also had nerve conduction studies to check for carpal tunnel syndrome in his wrist but after the chiro treatment it's never come back.

I've been led to believe that ultrasound picks up the tiniest tears and problems within the bursa and tendons?

I wanted to pay for a private scan weeks ago but he was convinced that the chiro would sort him out and now he feels guilty for "wasting" all that money, which would have paid for a scan twice over and I struggle not to say "I told you so" sometimes .

If he has pins and needles then it certainly sounds nerve based but it could be from a number of sources - not least from his cervical spine. How old is your DH? Basically once your in your late thirties you neck starts to deteriorate - some more than others.

If the chiro has stopped the pins and needles then perhaps it wasn't a waste of money? They may have released some of the pressure but not all. I only get a bit of numbness occasionally down to about my elbow but have the rest of the pain consistently.

Has the GP recommended the US? Mine went straight for the MRI and it only took about a month to get sorted.

Right, have spoken to the mother of little boy in DS's class and she said he had to have a GA to have it but that there was absolutely no pain afterwards and it has been very effective at paralysing the muscle/ligaments (?) as necessary. She also said she has a friend who has had the same treatment for neck pain and she herself may be a candidate in the near future due to all the lifting she has to do with her son as he cannot walk at all. As far as she knew, the treatment was effective for her friend too.

Is there anything specific beyond this you'd like me to ask about? I hope the fact that there has been no painful side effects for her son following treatment is reassurring.

Hobgoblin that's great, thank you for asking. When I had the steroid injections my shoulder reacted really badly to the point of making the pain worse so I was worried about more injections. It's good to hear such positive news. I will go ahead I think and fingers crossed I have some positive news to feedback to anyone who has similar issues.

Malificence and hobbgoblin, just to let you know I had the botox on Wednesday, good lord it hurts (or maybe I am a wus?). The first day I couldn't move my shoulder properly at all its was so tight and sore now it is just like it was before the injections. Will update when it starts to work (soon I hope!)

Thanks for the update Stripey - DH had a steroid injection last Thursday, unfortunately it doesn't seem to have made a difference, it really hurt him and the pain was worse for a couple of days , which we were told was a very good sign, but at the moment he says it's maybe 10% better.

He had an ultrasound scan yesterday and is going to the GP for the results today, the doc who injected him told him to come off the high strength co-codamols, which he did with some nasty withdrawal symptoms but he was back on the tramadol last night because he's woken frequently in pain for 3 nights running, he feels like he's back to square one because there were no obvious tears shown on the ultrasound so god knows if he will have any treatment.
He's back to being very fed up, he was hoping for some answers from the scan.

Hi Malificence, that sounds awful! I have to say, the steriod injections actually made my shoulder worse if anything, although they did take away the tenderness in my neck.

My shoulder is still very tight and sore today, they told me it would take about three days to start working so I am keeping my fingers crossed.

I hope the GP has some other routes for him to try, tell him to ask for an MRI to pick up any trapped nerves or tell him to ask to be referred to a pain consultant at the hosiptal - I don't know where you live so not sure if your local trust will have these.