Botox for Muscle Spasticity in London

Spasticity is stiffness and involuntary tightening of muscles. It happens when the brain or spinal cord has been affected, for example by a stroke, a brain or spinal cord injury, multiple sclerosis or cerebral palsy. It can make movement, walking, dressing and hygiene harder, cause pain, and make splints difficult to wear. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, gives Botox (botulinum toxin) injections into selected overactive muscles under ultrasound guidance, working alongside your physiotherapist and neurology or rehabilitation team.

Who it may help

Botox is used for focal spasticity, where a particular group of muscles is overactive, such as:

• a tight elbow, wrist or hand, or fingers that curl into the palm;
• a foot that points downwards or turns in, or toes that curl (see Botox for calf tightness and foot spasticity);
• tight muscles around the hip or knee that make movement or care difficult.

Before treatment, it helps to agree clear goals, for example easier walking, more comfortable splint wear, less pain or easier washing and dressing.

How Botox works

Botulinum toxin temporarily blocks the signal from a nerve to the muscle, so the injected muscle relaxes. It is an established treatment for spasticity. The effect usually starts within a few days, builds over two to four weeks and lasts around three to four months. The treatment can then be repeated if it helped.

Botox works best combined with stretching, physiotherapy and, where needed, splints or casting, so the relaxed muscle can be lengthened and the movement retrained.

Ultrasound lets Dr Sankaye see the target muscle directly, so the injection reaches the right muscle, including smaller or deeper muscles that are hard to find by feel alone.

What to expect

1. Assessment: Dr Sankaye reviews your history, current treatment and goals, and examines the affected muscles. We are happy to work from information from your neurology or rehabilitation team.
2. Injection: Botox is injected through a fine needle into the chosen muscles, each one located with ultrasound.
3. Afterwards: you can go home straight away. Starting or continuing stretching and physiotherapy is important in the weeks after the injection.
4. Review: the effect is checked against your goals once it has fully developed. A written report is sent to you and, if you wish, your GP, physiotherapist or neurology team.

Risks and side effects

• more weakness than intended in the injected muscles, for a few weeks;
• soreness or bruising at the injection sites;
• short-lived flu-like symptoms, which are uncommon;
• rarely, the effect spreads beyond the injected muscles and causes weakness elsewhere.

Botox may not be suitable if you are pregnant or breastfeeding, have myasthenia gravis or another condition affecting the nerves and muscles, have an infection where the injection would go, or take certain antibiotics (aminoglycosides). Please tell us about all your medicines, including blood thinners, before your appointment.

Seek urgent medical help if you have difficulty swallowing, speaking or breathing after a Botox injection. This is very rare.

Why choose LSRI

• Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
• Ultrasound-guided injection by a consultant specialist, so each muscle is targeted accurately.
• Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
• No GP referral needed, and all major insurers accepted.

Frequently asked questions

Will Botox cure my spasticity?

No. Botox reduces overactivity in the injected muscles for a few months. The aim is to make movement, comfort and care easier, and to help physiotherapy work.

How often can I have Botox?

Usually no more often than every three months. Many people have repeat treatments over the long term if each one helps.

Do I need a referral?

No GP referral is needed. If you are under a neurology or rehabilitation team, we will work alongside them and can share your report.

Other uses of Botox at LSRI

• Botox for calf tightness and foot spasticity
• Botox for plantar fasciitis
• Botox for trapezius and neck muscle pain
• Botox for excessive sweating (hyperhidrosis)
• Can Botox help Raynaud’s phenomenon?

See all our Botox injections.

Book an appointment

Call 0203 633 5040 or book online. Clinics at LSRI Harley Street (The Harley Street Hospital, 19 Harley Street, London W1G 9QJ) and LSRI Northwest London (Medic Care Direct, 62 Station Road, Harrow HA2 7SJ).