Botox for Trapezius and Neck Muscle Pain in London

The trapezius is the large muscle across the top of the shoulders and the back of the neck. Long-standing strain of this muscle can cause aching, tightness and tender knots, often made worse by desk work, posture, carrying heavy bags or stress. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, assesses neck and shoulder muscle pain and, for persistent cases, can offer Botox (botulinum toxin) injections into the trapezius under ultrasound guidance.

Who it may help

Botox may be considered for chronic trapezius strain or muscle pain that has lasted for months and has not improved enough with physiotherapy, exercise, posture and workstation changes, or other injections. It is not usually the first treatment.

Neck and shoulder pain is not always from the muscle. Dr Sankaye checks for other causes, such as a problem in the neck, the shoulder joint or the rotator cuff, and an MRI scan or ultrasound scan can be arranged if needed. See your GP promptly if you have neck pain with numbness, tingling or weakness in the arms, problems with balance, or a fever.

How Botox may help

Botulinum toxin temporarily blocks the signal from a nerve to the muscle, so the injected part of the trapezius relaxes. This can ease constant muscle tension and tender knots, giving a window for exercise and physiotherapy to work. The effect usually builds over about two weeks and lasts around three to four months.

Using Botox for trapezius and other muscle pain is an off-label use, and the evidence is mixed: some people benefit and others do not. Dr Sankaye will talk through whether it is likely to help you. Botox injections into the trapezius are sometimes called “Traptox”, but at LSRI they are given for pain, not for appearance.

What to expect

1. Assessment: Dr Sankaye reviews your symptoms and previous treatment, examines your neck and shoulders, and maps the most tender areas of the muscle with ultrasound.
2. Injection: Botox is injected through a fine needle into several points in the trapezius. Ultrasound guidance keeps the needle within the muscle and away from deeper structures.
3. Afterwards: you can return to most normal activities straight away. You will be given aftercare advice and exercises.
4. Review: the full effect is usually seen after about two weeks. A written report is sent to you and, if you wish, your GP or physiotherapist.

Risks and side effects

• soreness or bruising at the injection sites;
• temporary weakness when shrugging or lifting the arm overhead, or a feeling of a weaker neck;
• headache or short-lived flu-like symptoms, which are uncommon;
• rarely, the effect spreads beyond the injected muscle.

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.
• Diagnosis and ultrasound-guided treatment from the same specialist.
• 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

How many injections will I need?

Several small injections are given in one session, into the parts of the muscle causing your pain. If it helps, the treatment can be repeated, normally no more often than every three months.

Will it change how my shoulders look?

The dose used for pain is aimed at the painful areas of the muscle. Some people notice the muscle looks slightly less bulky while the effect lasts.

Do I still need physiotherapy?

Yes. Botox can ease muscle tension, but exercise, posture and workstation changes are what help the improvement last.

Other uses of Botox at LSRI

• Botox for calf tightness and foot spasticity
• Botox for plantar fasciitis
• Botox for muscle spasticity
• 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).