Botox for Neck and Back Pain

A nurse holds a needle.
Nerve blocks are spinal injections. H. Armstrong Roberts/ClassicStock Archive Photos/Getty Images

Botox for Back and Neck Pain

Although Botox is best known as a wrinkle smoother, it's been used (and studied) for its pain relieving properties.  Regardless of its intended purpose, Botox works its reported magic by blocking a neurotransmitter compound known as acetylcholine; this has the effect of rendering muscles and/or glands inactive, according to an evidenced based review published in the February 2013 issue of the Journal of the Royal Society of Medicine.

How Well Does Botox Relieve Neck or Back Pain?

Now that you know how Botox does what it does, you may want to know whether it really relieves pain, and, if so, which types.

Persaud, et. al., who are the authors of the review mentioned above, researched other reviews on the medical uses of Botox.  They learned physicians do not recommend using Botox as a chronic pain treatment to other physicians.  

One reason for this may be that pain relief from Botox injections seem to be on par with the amount of pain relief that can be had with injections of saline solutions, according to a 2011 Cochrane Back and Neck group* review.  In other words, the Cochrane researchers found good evidence that Botox is ineffective at relieving neck pain or improving functioning.

Related: Neck Neuropathy

Botox for low back pain has similar ratings with one important exception: Even fewer studies have been done to determine how well it relieves pain or improves your physical functioning. A different 2011 Cochrane Back and Neck review that looked at studies for low back pain found only low quality and very small studies.  The researchers for this review concluded that evidence from studies does not support using Botox for chronic low back pain relief.

One condition that does seem to respond to Botox, though, is cervical dystonia, or spasmodic torticollis.  Also known as wry neck, in this condition, neck muscles remain constantly contracting.  Wry neck causes neck pain and results in twisted or other awkward neck positions that are very difficult to relieve.

Related:  What is Wry Neck?

The Persaud review mentioned above found that single injection of Botox is effective and can be safely repeated if necessary. The authors say that Botox not only reduces abnormal movements and contractures associated with these conditions, but it also can prevent related spinal degeneration and radiculopathy.

The Tox in Botox

The true name of this drug, Botulinum Toxin, gives us a clue about it's nature.  Botox is a poison that can paralyze nerves, but as you've seen above may possess some healing power as well. Nigum, et. al., in their article "Botulinum Toxin", published in the Indian Journal of Dermatology, calls Botox the "miracle poison."

But in the hands of the wrong health practitioner (or, illegally, lay person,) this drug can have devastating effects on the nervous system. Until it is properly diluted and prepared, it remains poisonous. 

*Note:  I've been a consumer reviewer for the Cochrane Back and Neck Pain group since 2007.

View Article Sources
  • Source:
  • Nigam, et. al. BOTULINUM TOXIN. Indian J Dermatol. Jan-Mar 2010. Accessed Feb 2016.
  • Persaud, R., Garas, G., Silva, S., Stamatoglou, C., Chatrath, P., Kalpesh Patel, K. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. JRSM Short Rep. Feb. 2013. Accessed: Feb 2016.
  • Waseem, Z., et. al. Botulinum toxin injections as a treatment for low-back pain and sciatica. Cochrane Back and Neck. Jan 2011. Accessed April 2011.