Botulinum Toxin Injections for Muscle Spasticity in Adults

This leaflet gives you information about botulinum toxin injections for the treatment of muscle spasticity in adults.

Muscle spasticity is a continuous contraction of the muscles, causing stiffness or tightness, which can lead to problems with everyday activities and pain.

Spasticity is usually caused by damage to parts of the brain or spinal cord that control movement.

What is botulinum toxin?

Botulinum toxin is a naturally occurring chemical produced by bacteria and has been developed into a treatment for spasticity.

How does it work?

Botulinum toxin works by stopping the overactive muscles contracting (spasticity). This is done by preventing the release of a chemical between the nerve and the muscle, leading to temporary weakness and relaxation of the affected muscle.

How is it given?

The botulinum toxin is given by an injection into a single muscle or a small group of muscles that have been affected.

How long does it take to work?

The toxin takes effect gradually over 2 weeks, the maximum effect can be seen after 10 to 14 days. The effects of the toxin are temporary and can last between 3 to 4 months.

What are the benefits of treatment?

The main benefits of this treatment are:

• the toxin reduces the stiffness in those muscles that have been injected.
• to maintain or increase the range of movement.
• to reduce pain and discomfort.
• to improve posture.

Botulinum toxin is not suitable for people who:

• are allergic to botulinum toxin or human albumin (blood product).
• have an infection at the injection site.
• have had a botulinum toxin injection within the last 3 months
• feel unwell
• are pregnant.

Are there any side effects?

There can be some common side effects, although not everybody gets them, they can include:

• Pain or bruising at the injection site
• Flu-like symptoms (fatigue and headache)
• Excessive muscle weakness
• Skin rash/itchiness
• Temporary swallowing problems
• An allergic reaction to the Botulinum Toxin.  This is rare, however, if this happens you must contact the Emergency Department immediately.

Are there any other treatments?

Other treatments include oral anti-spasticity medications. These are used to treat generalised spasticity and not specific muscle groups. If you would like further information, please speak to your Consultant.

What will happen before the injection?

You will be seen by your Consultant who will again explain the reasons for your injection and the injection itself. When you fully understand the procedure you will be asked to sign a consent form, if you have not already done so. 

You will only be asked to sign the consent form before your first injection.  This will cover you for any future injections, if needed.

What will happen after the injection?

Following your botulinum toxin injection, you may be given a range of stretches and exercises which you will be expected to carry out at home and/or a specialist splint.

It is important that you follow the advice given, as this will maximise the effect of the botulinum toxin.

Will I need to attend a follow-up appointment?

A follow-up appointment letter will be sent to you.  The length of time between your appointments will depend on your Consultant.  This will be discussed with you.

Contact numbers

If you need further advice, or have any problems, please contact:

North Tees and Hartlepool NHS Foundation Trust

Community Stroke Team

Single Point of Access (SPA) telephone: 01429 522500

Opening hours: 8:30am to 5:00pm (Monday to Friday)

Emergency Department

24 hours a day, 7 days a week.

Telephone: 06142 382899

NHS Choices

Telephone: 111 (when it is less urgent that 999).

Calls to this number are free from landlines and mobile phones or via the website.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]