You may be familiar with Botox as a go-to cosmetic treatment for smoothing out wrinkles, but did you also know it can provide relief for some people living with multiple sclerosis (MS)?

Botox, a brand name for the drug onabotulinumtoxinA, acts as a temporary muscle relaxant. Botox is made from Clostridium botulinum, a potentially deadly neurotoxin. However, in small amounts, this medication can safely relax muscles and is sometimes used to treat MS symptoms and other medical conditions.

Botox is a form of botulinum toxin type A, given through intramuscular injection (injection into the muscle) to treat muscle spasms in MS. Two other types, abobotulinumtoxinA (Dysport) and incobotulinumtoxin A (Xeomin), are also used to treat MS symptoms.

Some MyMSTeam members who’ve tried botulinum toxin treatments have discussed their experiences. “Well, here we go yet again. It’s time for my Botox treatment. I never knew that Botox was for things other than getting rid of crow’s feet,” wrote one member.

In MS, the immune system malfunctions and attacks the nerve fibers in the central nervous system (CNS). Botox injections are sometimes used to treat symptoms such as spasticity (muscle stiffness or tightness), problems with mobility, bladder control, migraine headaches, and vocal cord problems. Botox can help relax involuntary muscle contractions caused by nerve damage.

Botulinum toxin therapies may offer short-term symptom relief, but they don’t affect the underlying disease process of MS. Disease-modifying therapies are used to help slow MS progression.

Continue reading to learn how therapies like Botox, Dysport, or Xeomin may relieve some MS symptoms. If you think botulinum toxin treatment might help manage your MS symptoms, talk to your neurologist (a doctor who diagnoses and treats CNS disorders).

1. Botulinum Toxin Could Calm an Overactive Bladder

Bladder problems can be a particularly uncomfortable symptom of MS. Muscle spasms in the bladder and urinary sphincter — the muscle that opens to release urine — can cause urinary incontinence or an overactive bladder. You might experience leaking of urine, frequent or weak urination, or an urge to urinate (day or night) that comes on suddenly and is hard to control.

As cited in the journal Neurology, a study of 144 participants with MS found that onabotulinumtoxin A significantly reduced bladder dysfunction. More than half the participants had a 100 percent reduction in urinary incontinence after six weeks.

As some MyMSTeam members have shared, these treatments can help improve quality of life for some people. “Botox has been a life changer for me — no more leaks or wet seats,” a member wrote. Another member said, “I’ve gotten my second Botox to my bladder and must say it’s definitely an improvement.”

A healthcare provider can inject botulinum toxin into the bladder muscle using a procedure called cystoscopy. A very small camera and needle are inserted through the urethra (where urine comes out of the body). The procedure is usually done under local anesthesia (medication that numbs a single area).

Possible side effects include pain, bloody urine, and infection. The treatment is temporary and can’t be repeated for at least three months.

2. Botulinum Toxin Might Improve Mobility and Painful Muscle Spasms

Muscle spasticity in MS causes stiff, tight muscles and involuntary or jerky movements that can be painful and disruptive to daily life.

Botox for spasticity in legs and other muscles can be effective when just a few areas of the body are affected. This treatment is commonly used as a muscle relaxant in movement disorders such as cervical dystonia, a type of muscle contraction that can cause abnormal and painful movement in the head, neck, and shoulder. A review of eight studies found that botulinum toxin type A improved pain and function for most participants but also increased the risks of swallowing difficulties and fatigue.

Botox for muscle spasms in legs can help improve mobility, which spasticity may otherwise limit. In the journal Toxins, one observational study of 125 people with MS showed that botulinum toxin injections helped many participants achieve their goals of improved mobility and gait.

“I get Botox every three months in my left leg to help with walking,” a member wrote. Another said, “I have regular Botox to help with problems in my foot/big toe. It’s effective for a while but does wear off!”

A healthcare provider administers injections into muscle groups that are targeted for treatment. This outpatient procedure typically lasts between 30 and 45 minutes. Common side effects include pain and soreness at the injection site and temporary muscle weakness.

3. Botulinum Toxin Can Relax Vocal Cords

MS can affect vocal cord muscles, making speaking difficult. According to MS Focus Magazine, around 40 percent of people with MS experience speech issues. This complication can be due to muscle problems in the mouth, throat, jaw, or vocal cords.

Botulinum toxin treatments can help relax and lengthen vocal cord muscles in people with spasmodic dysphonia (a disorder affecting the voice box) to improve function. Several techniques are used for injections in the vocal cords, such as inserting a small camera and needle through the nasal cavity or inserting only a needle through the throat. The procedure is usually performed in a doctor’s office with local anesthesia. Possible side effects include difficulties in swallowing, breathiness, and breathing in fluids.

“Yes, the Botox does help,” wrote a MyMSTeam member. “I see an otolaryngologist for those treatments. It lasts about three or four months. Otherwise, I would also find myself trying to avoid conversations with people. It was extremely difficult when I was working because my job required me to talk to lots of people daily.”

“I finally went back to the doctor for another Botox treatment for the vocal cords,” another member said. “For the next couple of weeks, I will sound as if I am whispering, and then my vocal cords should ‘relax’ for a few months. Brief relief!!!!”

4. Botulinum Toxin Injections Might Reduce MS Migraine Attacks

Botulinum toxin may help treat chronic migraine headaches, a common condition in people with and without MS. Although clinical trials have shown that botulinum toxin can be effective, researchers don’t fully understand how it works. Studies suggest the treatment may block pain pathways in the CNS.

One MyMSTeam member wrote, “My neurologist gives me Botox every 90 days for migraine, and I must confess I haven’t had a migraine for almost one year.”

“I’ve used Botox for migraine,” another member said. “When she was doing the shots, she noticed my neck was really stiff and did injections there, too. It really helped both issues a lot. I go every 90 days for Botox.”

Botulinum toxin treatments for migraine are administered by a clinician who injects it through a tiny needle into very small muscles in the head and neck. The injections may be targeted at trigger points where migraine headaches originate. Some people don’t experience relief for several weeks, and it may take a few treatments until migraine headaches subside.

Discuss Botulinum Toxin Side Effects With Your Doctor

Although botulinum toxin is generally considered safe and may be an effective treatment for some MS symptoms, there’s a risk of rare but serious side effects such as:

• Breathing problems
• Swallowing problems that may last for months
• Muscle weakness throughout the body
• Difficulty speaking
• Blurred or double vision

More common side effects include flu-like symptoms and injection site bruising, pain, swelling, or infection.

Botulinum toxin can be hazardous, and injections can potentially spread beyond the intended muscle group. If this complication happens, botulism symptoms can occur within hours, days, or even weeks after an injection. Some individuals develop a resistance to botulinum toxin because their immune system produces antibodies (proteins) against it, especially after multiple treatments.

Injection Costs and Health Insurance Coverage

If you and your doctor determine that botulinum toxin may be an appropriate treatment option for you, check with your health insurance company to see if they’ll cover it. Botulinum toxin therapy has been approved by the U.S. Food and Drug Administration (FDA) for treating spasticity, but coverage can vary among insurance providers.

You may qualify for savings programs offered by the drug companies that manufacture botulinum toxin treatments. If you meet certain requirements, these programs can help with out-of-pocket costs such as copays, deductibles, and coinsurance. You can learn more at these websites:

• Botox Savings Program
• Ipsen Cares (support for Dysport treatment)
• Xeomin Patient Savings Program

Note that botulinum toxin therapy is not a cure for MS and should be used only as one part of a treatment plan. These injections may have side effects, such as muscle weakness and difficulty swallowing. Make sure to discuss side effects with a healthcare professional before considering treatment. Your doctor will carefully assess whether this treatment is appropriate for you and give you medical advice, taking into account your medical history and any other drugs you’re taking.

Talk With Others Who Understand

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, more than 218,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Have you tried Botox or another botulinum toxin treatment for your MS symptoms? Did you find that it helped your MS symptoms? Share your experiences in the comments below, or start a conversation by posting on your Activities page.