Botox and Dysport injections use purified botulinum toxin type A to relax overactive muscles and ease pain, helping patients with chronic migraine, spasticity, and dystonia at Columbia Pain & Spine Institute in Gresham and Portland, Oregon.
OVERVIEW
What Botox and Dysport injections are and how they work
OnabotulinumtoxinA (Botox) and abobotulinumtoxinA (Dysport) are formulations of botulinum toxin type A, a protein that temporarily blocks the release of acetylcholine, the chemical signal nerves use to trigger muscle contraction. Injected in small, carefully measured amounts, the medication relaxes the targeted muscle. For headache, it is also thought to reduce the peripheral pain signaling that contributes to migraine.
For chronic migraine, Botox is injected into a defined set of muscles across the forehead, temples, back of the head, neck, and shoulders. For spasticity and dystonia, the injection eases the involuntary muscle tightening or twisting that limits movement and causes discomfort. The effect is temporary and reversible, so treatment is repeated at intervals to maintain benefit.
It is worth noting that Botox is the formulation specifically FDA-approved to prevent chronic migraine, while both Botox and Dysport are used for muscle spasticity and dystonia. Our dual board-certified, fellowship-trained PM&R physicians choose the product, muscles, and dosing based on your diagnosis and exam findings. This procedure is one of several described in our other interventional procedures and full list of services.
CONDITIONS
Conditions botulinum toxin injections may help
Botox and Dysport injections are typically considered when symptoms have not responded adequately to other treatments. Common indications include:
Commonly treats
YOUR VISIT
What to expect
Before
Your physician reviews your headache history or movement symptoms, prior treatments, and medications. Tell us if you take blood thinners or have a neuromuscular condition such as myasthenia gravis or ALS. No sedation or general anesthesia is needed, and most patients can drive themselves to and from the visit.
During
The treatment is performed in our office using a very fine needle, with injections placed at multiple sites depending on the area treated. The chronic migraine protocol, for example, typically uses about 31 injections across seven head and neck muscle areas. For deeper or specific muscles, ultrasound or electromyographic (EMG) guidance may be used to position the medication accurately. The appointment is usually brief, often 15 to 30 minutes.
After
You can usually return to normal activities the same day. We may ask you to avoid rubbing the treated area and to skip strenuous exercise for a short time so the medication stays where it was placed. Mild soreness, redness, or a small bruise at injection sites is common and short-lived.
Recovery and results
The muscle-relaxing and pain-relieving effect develops gradually over several days to about two weeks rather than immediately. Because the medication wears off over time, treatment is commonly repeated about every 12 weeks (roughly three months). Individual responses vary, and your physician will set a schedule based on how you respond.
RELATED PROCEDURES
Related treatments
Depending on your diagnosis, your physician may discuss other targeted options alongside or instead of botulinum toxin injections:
Trigger Point Injection
Injections into tight, painful muscle knots that contribute to myofascial and tension-related pain. Learn more
Occipital Nerve Block
A targeted injection at the back of the head used for occipital neuralgia and certain headache and migraine patterns. Learn more
Platelet-Rich Plasma Therapy
A regenerative injection option for select musculoskeletal and soft-tissue conditions. Learn more
FAQ
Frequently asked questions
Does the injection hurt?
Most patients tolerate the injections well. A very fine needle is used, and the sensation is usually a brief sting or pressure at each site. Any soreness afterward is typically mild and resolves within a day or two.
How long until I notice a difference?
The effect is not immediate. It generally develops over several days to about two weeks as the medication takes hold. Individual responses vary, and your physician will review what to expect for your specific condition.
How often will I need treatment?
Because botulinum toxin wears off over time, injections are commonly repeated about every 12 weeks to maintain relief. Your physician will tailor the interval to your response and symptoms.
Is Dysport the same as Botox?
Both are botulinum toxin type A and work in similar ways, but they are dosed differently and are not interchangeable unit for unit. For chronic migraine, Botox is the FDA-approved option; both are used for spasticity and dystonia. Your physician will recommend the product best suited to your condition.
NEXT STEPS
Talk with our Gresham and Portland team
If chronic migraine, spasticity, or dystonia is affecting your daily life, our pain specialists can help determine whether Botox or Dysport injection is appropriate for you. New patients are welcome by referral. Contact us with questions, and referring providers can fax records to (503) 382-8120.
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