The new MIRACLE drug?
The word conjures images of celebrities and wrinkles, but Botox is a fast-emerging tool for relieving pain and disabilities. St. Paul researchers are using it to relax the limbs of cerebral palsy patients.
Moments before her Botox shots, 3-year-old Tori Jorgenson is smiling and laughing. She's about to get some needed relief, but not from crow's feet or laugh lines.
Tori routinely visits the Botox Clinic at Gillette Children's Hospital in St. Paul. She has cerebral palsy, and the shots relax the spastic muscles in her arms and legs, letting her walk more easily.
She endures the shots to her wrists and arms but begins to cry as she feels the painful injections to her legs.
"If the Botox didn't work so well, we probably wouldn't do this," said her mother, Casey Jorgenson.
While publicly associated with celebrities and disappearing wrinkles, Botox also is a fast-emerging tool for doctors in relieving pain and disabilities. In addition to cerebral palsy, Botox is used locally in clinical research for everything from sore shoulders to skin diseases to headaches.
"You can use Botox for a lot more clinical problems than we originally thought," said Dr. Dennis Dykstra, chair of the Department of Physical Medicine and Rehabilitation at the University of Minnesota Medical School. "It's fascinating stuff."
Fascinating in part because Botox is a form of the botulinum toxin, associated with outbreaks of food-borne illnesses and the sometimes-fatal disease botulism. Local researchers are trying to learn more about how Botox works and how it could be applied to other forms of chronic pain.
One known way Botox works is by blocking chemical signals from the brain that tell nerve endings to move muscles, said Dr. Mark Gormley, a pediatric rehabilitation specialist who treats Tori. Injections into select nerves in Tori's legs stop the spasms that make walking difficult. Shots every three months allow Tori to color, walk with a walker and play with her 16-month-old twin sisters, her mother said. Without the shots, Tori scissors her legs as she walks and has trouble with some preschool activities. Elsewhere in
he Twin Cities, doctors are testing Botox in ways that have yet to be approved by the U.S. Food and Drug Administration. Botox appears to reduce shoulder pain for patients with osteoarthritis, said Dr. Jasvinder Singh, a staff physician at the Minneapolis Veterans Affairs Medical Center.
Singh and his research team injected Botox or saline into the shoulder joints of 43 patients. After one month, 38 percent of patients who received Botox injections reported a significant reduction in pain levels. Only 9 percent of those receiving saline injections reported the same benefit. A larger study is needed to confirm these findings, though, and should compare patients at varied doses of Botox, Singh said. Some who received Botox reported an improvement in shoulder function, but there was not a significant difference compared with those who received saline. "This could be because the improvement in shoulder function might lag behind improvement in shoulder pain," he said. More improvement might show up in patients three to six months later. Based on his findings, Singh also wants to explore whether Botox has a painkilling effect in addition to its effects on nerve endings. He is recruiting knee-replacement patients with persistent pain for another study. Dykstra, the U physician, has researched the effectiveness of Botox injections for conditions like overactive bladder, psoriasis, pelvic floor pain and carpal tunnel syndrome, among others. He and other researchers are trying to discover if Botox can reduce inflammation in addition to its painkilling effect. The Park Nicollet Headache Clinic and Research Center has just finished recruiting patients to see if Botox can treat chronic migraine headaches and can receive FDA approval for that purpose, said Dr. Frederick Taylor, the clinic director. Taylor said Botox still has skeptics: "There are many people who think the results we've seen in studies of Botox are due to a placebo effect." The use of a needle in treatment can strongly influence patients to believe they feel better, he said. More large studies are needed to prove the experimental uses of Botox truly have an effect. Suzanne Sobotka can be reached at ssobotka@pioneerpress.com or 651-228-5251.
HOW BOTOX WORKS
Botox blocks the chemical signals to the brain that tell nerve endings to move muscles. Doctors inject it into select nerves to stop muscle spasms, enabling movement in those with cerebral palsy.
WHAT ELSE COULD BOTOX DO?
Researchers studying the botulinum toxin are finding:
It appears to reduce shoulder pain for patients with osteoarthritis.
It could have a painkilling effect.
It could reduce inflammation.
It may help conditions such as overactive bladder, psoriasis, pelvic floor pain and carpal tunnel syndrome.
source: http://www.twincities.com/ci_7687158?source=rss&nclick_check=1
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