Living with spasticity or dystonia—whether from stroke, cerebral palsy, brain injury, or a neurological condition—can be painful, frustrating, and limiting. One of the tools I offer to help manage these symptoms is therapeutic botulinum toxin treatment.
This is a well-established, evidence-based treatment used to relax muscles that have become overactive or stiff. By carefully targeting the specific muscles causing discomfort or difficulty with movement, we can reduce pain, improve mobility, and make everyday tasks more manageable.
Therapeutic botulinim toxin treatment is tailored to each person’s needs and goals. Whether it’s improving the position of a limb, easing muscle cramps, or helping with walking or dressing, my goal is to make life a little easier—and more comfortable—where we can.
If you or someone you care for is struggling with spasticity or dystonia, know that there are options. I’m here to help you explore them in a way that feels informed, respectful, and hopeful.
A: Therapeutic botulinum toxin is sometimes called “botox,” but technically, BOTOX® is just one brand name of botulinum toxin type A. Another brand is also available in South Africa.
Both therapeutic and cosmetic botox use the same active substance, but the purpose is very different. In neurology, the treatment is used to relax specific overactive muscles—helping to relieve stiffness, reduce pain, and improve function. Cosmetic botox, by contrast, is used in much smaller doses to soften facial lines and wrinkles.
Botulinum toxin works by temporarily blocking the nerve signals that make muscles contract, giving them a chance to relax.
A: Botulinum toxin can help with:
A: The injections are generally well-tolerated. Some people feel a small pinch, and in most cases, I use an ultrasound machine to make it as precise and comfortable as possible.
A: You may start to feel the effects within three to seven days, but full results are usually seen after about two weeks.
A: The effects typically last between 3 and 4 months, and the treatment can be repeated when needed.
A: Most people tolerate it well. Side effects are uncommon but can include mild weakness in nearby muscles, temporary soreness at the injection site, or flu-like symptoms. We discuss all potential risks before treatment.
A: Botulinum toxin doesn’t cure the underlying condition, but it can significantly reduce symptoms and improve comfort, mobility, and independence.
A:Some patients are referred by their doctor or physiotherapist, but you’re also welcome to get in touch directly if you’d like to explore whether this treatment could be helpful for you or a loved one.
A: People experiencing muscle stiffness, spasticity, or involuntary movements due to neurological conditions such as stroke, cerebral palsy, dystonia, or brain and spinal cord injuries may benefit from treatment. The best way to know if you’re a suitable candidate is through a neurological assessment.
A: It relaxes overactive muscles by blocking the nerve signals that cause them to contract. This can reduce pain, improve movement, and make everyday activities easier.
A: Yes. Dr. Townsend provides evaluation and treatment for pediatric spasticity with therapeutic botulinum toxin injections when appropriate.
A: Yes, it is widely used to help children with cerebral palsy reduce muscle tightness and improve function. The dosing and treatment plan are tailored to the child’s age, needs, and developmental goals.
A: Most patients receive treatment every 3–4 months, as the effects gradually wear off. Your follow-up schedule will depend on your condition and how your body responds.
A: Absolutely. In many cases, combining botulinum toxin with physiotherapy, stretching, and other rehabilitation strategies maximises functional outcomes.
A: There is no downtime. Most people return to normal activities immediately after their appointment.
A: A typical treatment session lasts 40-60 minutes, depending on how many muscles are being treated and whether ultrasound guidance is used.
A: You can continue most normal activities. Your clinician may advise avoiding vigorous exercise or rubbing the injection area for a short time.
A: You may be asked about your medications, previous treatments, and goals for therapy. In most cases, no special preparation is needed, but this will be discussed during your initial consultation.
A: Many patients report reduced pain, easier movement, improved independence, and better participation in daily activities. While it isn’t a cure, it can make a meaningful difference.
A: Some medical aids may cover therapeutic botulinum toxin for approved PMB medical conditions such as cerebral palsy, post-stroke spasticity, and multiple sclerosis. Coverage varies, so it’s best to check with your provider.
A: Some people notice mild temporary weakness in the treated muscles, but this usually settles within a short period. Dr Townsend will discuss what to expect.
A: Yes, it can be used to target specific overactive muscles in the hand, wrist, or forearm to improve positioning and reduce discomfort.
A: Ultrasound allows for extremely precise targeting of the affected muscles, improving accuracy, comfort, and treatment outcomes. Many clinicians recommend it for optimal results.
