Yes, Botox can work to help with symptoms such as spasms and muscle function tied to multiple sclerosis. There are pros to this treatment, but also possible downsides to using Botox for MS.

Multiple sclerosis (MS) is a progressive condition that involves the immune system attacking and destroying healthy nerve cells in the brain and spinal cord.

The condition’s resulting neurological effects cause changes in muscle function—known as spasticity—that can affect the body’s ability to move on command and cause repetitive movements, such as bladder spasms.

Your doctor may prescribe different medications to treat MS. But in addition to those meds, they may also order botulinum neurotoxin (Botox) for MS to treat spasticity.

The Food and Drug Administration (FDA) approved three formulations of botulinum toxin injections to treat multiple medical conditions, including:

  • onabotulinum toxin A (Botox)
  • abobotulinum toxin A (Dysport)
  • incobotulinum toxin A (Xeomin)

Each of the above formulations can help stop the transmission of nerve signals to the affected muscles near the injection site. This paralyzes those muscles, to stop them from tensing or contracting, in order to relax.

People may often know Botox as a treatment for wrinkles. The injection smooths wrinkles by paralyzing muscles, offering an appearance of smoother skin.

But doctors can use Botox in many capacities, such as to reduce sweating and treat spasticity after stroke.

For people with MS, the benefits may include spasm relief and help with muscle tone and function.

Doctors use Botox to treat spasticity in specific muscle groups. This can include individual muscle groups, including those that affect:

  • ankles
  • biceps or elbows
  • toe or finger flexors, including the thumbs
  • wrist
  • shoulder muscles
  • hip muscles

Doctors can also use Botox to treat people with MS who have overactive bladder (OAB), tremors, and migraines.

The effects of MS can cause overactive bladder contractions — and this can lead to incontinence, frequent urination, or feeling like you need to pee constantly.

The procedure to inject Botox for MS depends on where the doctor injects the Botox.

For example, if your doctor injects Botox into an arm or leg muscle, they may do the following:

  1. Identify the most affected muscles: Doctors will physically examine your muscles and movements, and may also use an ultrasound or electromyography (EMG) machine to help identify muscles and find the best place for the injection.
  2. Inject Botox into a muscle: They may inject into the muscle using a small, fine needle.
  3. Place several small injections around the muscle: The several small injections are because Botox doesn’t usually spread far beyond where the doctor injects it.
  4. Instruct you to limit some activities: Certain activities can reduce the injection’s effectiveness, so they may want you to not move those muscles near the location of the injection.

For Botox injections in the bladder, the procedure typically involves gettig a local anesthetic injection or general anesthesia.

Botox may relieve spasticity immediately, but it can sometimes take a few weeks to notice its effects.

The most immediate side effects after injection include:

  • bleeding, usually minor
  • bruising
  • muscle soreness
  • pain at the injection site

Rarer side effects reported in the study above included:

Benefits

  • Can reduce spasticity symptoms
  • Pain relief from spasms may last for 3 to 4 months
  • Enhanced flexibility and range of motion in affected muscles

Downsides

  • Results may last several months, but you will require repeat treatments and that may mean getting injections without much time in between. Over time, Botox can become less effective.
  • Severe spasticity symptoms are typically less responsive to treatment with Botox.
  • You may experience disruptive side effects, such as significant muscle weakness.

Botox isn’t as invasive as surgery, but it does involve injecting a substance into your body.

For this reason, it isn’t usually a first-line treatment for MS symptoms. Botox may be an option if your symptoms don’t respond well to other treatments, or if you experience side effects from those medications.

Sometimes, spasticity can cause severe muscle contractions, which can make it difficult to move muscles. A 2016 international task force studying this issue on Botox for MS spasms specifically found that Botox may not be effective when these severe muscle contractions occur.

Muscle spasms from MS can be treated with Botox injections, oral and other medications, or spinal pump placement for anti-spasticity medication. Your doctor and healthcare team can best guide you on what treatment options may work best for you, based on your MS symptoms and overall health.

Doctors may use Botox to help relieve muscle spasms, tone, and function that people with MS may experience. This can include MS symptoms in the upper and lower limbs, and in the bladder.

Consult your doctor if you have MS and believe that Botox may help your spasticity — especially if other treatments haven’t worked.