When people think of botox their minds usually conjure images of plump lips and frozen foreheads. But few people know that botox injections are also a widely-used treatment for a range of medical conditions including stiff neck, sweaty armpits and migraine headaches. Botox can also be an effective treatment for severe forms of pelvic pain.
Pelvic pain is the umbrella term for ongoing pain caused by a variety of issues including endometriosis, bowel and bladder pain, or injury. When pain continues, the surrounding muscles react by becoming tight and painful, and can sometimes go into spasm and cramp.
When pelvic muscles become over-contracted, they cause sporadic sharp pain and also give pain with intercourse, or when using your bowels or bladder. This pain can have a big impact on the sufferer’s quality of life, sometimes leaving them unable to go to work or undertake normal daily tasks.
Generally, the first line of treatment for pelvic pain is physiotherapy and at-home exercises. Botox injection is usually used for more severe cases, where physiotherapy alone has not been effective.
Basically, the botox works to weaken or paralyse the spasming muscle for a period of time, usually lasting around six months. The injection is usually a short day procedure in hospital, with no cuts or stitches. Because the muscles involved are deep, the procedure is usually performed under general anaesthetic, although local anaesthetic may be used in some cases.
In order to determine if this treatment could be right for you, your doctor will first want to better understand your pelvic pain. They will look at your medical and surgical history, your symptoms and any treatments you have already tried, and will conduct a pelvic and vaginal examination and also perhaps an ultrasound.
Studies have shown that the injection will almost always cause relaxation of the affected muscles. However, this does not always result in decreased pain. About 75% of women will have a good response to the injection and good relief of pain symptoms. It may take 1-2 weeks to feel the effects of the injection, and these will usually last about 6 months, but this can vary. There have been cases of women who, after a single injection, experience a complete resolution of their pain symptoms for more than 5 years.
There are relatively few side effects associated with this treatment. These may include local pain and bruising at the site of the injection, and bladder- and bowel-control issues. These effects are rare and temporary. There have been a small number of women who have had a reaction to the injection in the form of local pain, swelling and flu-like symptoms.
The injection will not affect your fertility or ability to have a normal vaginal birth. But it is not recommended that you have injections through your pregnancy and you should not try to become pregnant for 6 months after an injection.
If you suffer from severe pelvic pain, you can speak to one of our gynaecologists who specialises in chronic pelvic pain or see our physiotherapist for pelvic pain physio. Most patients will require a multidisciplinary approach to pelvic pain which can include a pain psychologist, a pain specialist, support groups, pharmacological therapies and, in some cases, surgery.