Hi everyone- I just had Botox placed into my pelvic floor muscles 5 days ago. I was wondering does anyone know how long it will take for the muscles to start relaxing?
When does Botox start relaxing muscles? - Pelvic Pain Suppo...
Pelvic Pain Support Network
I am probably going to get it if pt and muscle relaxers still leave me with some issues...I have seen people post that it can take up to a month to work and usually you need it done 3 times a few months apart...some people it works well for and others it doesn't work....my mind is boggles with it all...and it is exhausting when you have to work and take care of kids....hope it works for you and please keep us posted
I used to have Botox in my neck for dystonia, it used to take a couple of weeks for me to start working, then I needed it repeating every 3months. Hope it helps you.
Hi Suzie...was just wondering if the botox worked for your dystonia?and also what is dystonia?
Dystonia is muscle contractions and movements that you cannot control, so my head always looks to the right. You can have it in other body areas or several at a time. Yes the Botox did help. I did stop having it, due to feeling as if I had flu like symptoms. I did think it was because the doctor put it all in the same spot instead of spreading it around my neck, so I never went back.
Ok so that's what my family has we think......they are in the UK where I am from and 3 of my first cousins started falling down when they were 7-8 and would be end up having contorted bodies and difficult y walking and really they just said it was dopa dystonia...and another doctor Said it was juvenile Parkinson's which my grandmother and my Uncle had....now my cousin has a 16 year old son and his neck has always pulled to one side and he wore leg braces for years...it's frustrating because the doctors they go to said it's not dystonia like my other family members but my sister and I think it is...I just wanted to hear what you said about dystonia because I don't meet many people who know about it...have you had that since you were younger and do any members of your family have it?I am just glad to have someone to talk to about it so anything you can tell me would be helpful
Sorry to here about all your family problems. I am in the UK too. I first noticed the dystonia in my early thirties. Doctors still do not know the cause, it could be secondary to some other illness. London Queens square hospital is the best place to go for a diagnosis for movement disorders. I have twitching muscles all over my body, weak muscles, numbness and tingling. I do have symptoms of ataxia so I am waiting for these tests. I was diagnosed with myoclonic dystonia in London. I went on the genome study and I have a variant in the PNKD gene, but doctors do not think this is the cause or if it is it would be very rare form. My problems are every day but PNKD attacks are not very often. Genetics still has a long way to go in knowing for certain. My dystonia seems to be spreading in my back and foot.
Hi thank you! Ok, so I think that it must work the same way in the pelvic floor as other areas in the body. Thank you again, and good health to you!
Update? I had Botox in my pelvic floor 2 weeks ago and am still waiting for relief. In fact, it feels like I’ve had an increase in pain! I hear that can happen though. How are you feeling?
Hi there! I am doing ok...I had my procedure 3 weeks ago tomorrow. I had 100 units of Botox into my pelvic floor and bilateral pudendal nerve block. I am having some problems with my R obturator internus muscle and my pudendal nerve. So the first 7 days I had some tightening occur then things settled down a little. I feel like my pudendal nerve has been bothering me bilaterally since injections near my obturator internus muscle. However, I am not sure if I just need stretching and lengthening internally near both obturators. My therapist has been out of town and I have only had therapy once. So I am still unsure what is going on with me. I do know that I have been able to decrease the flexeril I was taking since the injections so that is a plus! They say it can take up to 4 weeks to get complete effects. How about you.. how many units of Botox did you receive?? Have you resumed pelvic PT? Thank you so much for messaging me. It will be nice to follow with you as we had are injections around the same time. Hope you feel better everyday.
I’m not sure how many units I got. But I’ve been in pt for 5 1/2 months and making slow improvement—though it’s very up and down. At the suggestion of my pt, I got Botox in my levators, obterators, and piriformis muscles 2 weeks ago today; the idea being that we can speed up our progress in pt with the muscles more relaxed. I’ll be honest and say it hasn’t helped yet. And in fact this second week feels like spasm city. But I’m encouraged to read that plenty of people say it can get worse before it gets better and that it needs more than 2 weeks to really become noticeable.
PT is key I think no matter what so stick with it. It’s a long road. And you should measure progress in things you can do that you couldn’t do before. Hoping we both feel relief soon!
Hi! Yes, I thought I was having an increase in spasms in some muscles as well, especially my obturator muscles. They have been burning especially on the right. Do you by chance have any burning with your obturator muscles? Yes, I know PT is the key it has been a little challenging for me. Some therapist just have not worked out. I was also wondering how frequently can you have the Botox?? (Hopefully you won’t need it again) I have been told in 3-4 months and 5-6 months. I think I will end up needing two. Not sure if you have started back to pelvic PT yet but I was really sore the first time and had an I tease in muscle spasms. Not sure if that was just me. I have not had much PT since my surgery. MY therapist has been out of town. I am starting back tomorrow on my usual schedule though. So keeping my fingers crossed. I would love to hear how you progress and if you have any questions I will do my best to help. Yes, hoping for relief and better days soon as well- Take care.
Hey, so I have absolutely had crazy burning which my pt says is obterator-related. That has gone way down and she says my obterator feels pretty good now. The reason I believe is that this muscle crosses over the pudendal nerve. If the obterator is tight, you can get nerve irritation (burning).
My levators are still tight though and we’re working those. Today marks week 2 post Botox and I’m not sure how I feel yet. My pt says my muscles feel way more relaxed, so that’s something. Hopefully the days ahead will bring some relief.
That’s a good point about pt after the injections possibly causing a reaction while the muscles are still tender. Perhaps that was my experience as well.
Either way, good luck to you. Happy to stay in touch. Remember that this is a tough condition but they are muscles and muscles can be retrained and healed. These bastards are just very stubborn. Stick with it, my friend. We’ll get there!
Hi! So I just had therapy a couple of times this week. (My therapist has been out of town since my Botox procedure.) Anyway, I have to say things really went into spasm after PT on Tuesday and I had a lot of spasming the day after. Today I only had spasming for about 1/2 hr after therapy. I am hoping after a few more sessions to not feel so tight. I just think I might need to get things moving. My obturator muscles bilaterally are still burning intermittently. One is always bothering me with that pudendal nerve. I am glad to hear your obturator muscles have calmed down for you... I think I have a long road ahead of me unfortunately. I think that as time goes on the Botox will relax more and will metabolize out. That is the great thing about Botox.. if you don’t like it or maybe you received a little more than you needed, it is not forever. I still have a lot of trigger points and tender spots, but my therapist says the muscle seems to relax much easier.. Every day my pelvic floor seems different it is hard to explain... tight with different sensations. I attribute it to the Botox. I do have to say that since I have had the Botox I have been able to significantly reduce my flexeril. That is a sure sign that the Botox has to be helping even though I feel crappy some days. I know you just had your Botox 2 weeks ago, so you are still in that waiting period of 4 weeks they say. Anyway, hang in there and please let me know how you progress. Hope you are feeling better soon.
Thanks for keeping in touch. Honestly, today has been extremely hard and reminds me of when I first started my journey. Last night was bad too. It’s odd, because I was doing much better even if I still felt I had a ways to go.
This pretty much confirms for me that the Botox has caused a big-time flare but hopefully, as I have read about, that will end and lead to actual relief! My pt says the muscles are feeling more relaxed so that’s good.
It sounds like you are making progress and I can certainly sympathize with the ups and downs you are going through. It really does feel like a new sensation every day, doesn’t it?
Anyway, I’m struggling but I know I’ve felt better than this so I’m hanging on. Hoping to report bigger gains soon!
I will say, and maybe this is my imagination, but it feels like things might actually be more relaxed even if they are more in pain or more tender. Hard to know for sure.
Hi there! I am sorry you are having such a bad day and have a lot of pain. Honestly, I just went through this Tuesday night. I could not fall asleep until 2 am, burning nerve pain all night long, wondering what have I done to myself, and then the therapist tells me “Oh everything feels so much more relaxed” Yeah right!! I am not sure what medicine/ muscle relaxers you were taking prior to the Botox, but have you been able to decrease anything? You have not had to increase I hope?? Being able to decrease the flexeril is really the only sign I have had so far that the Botox is doing anything for me. It’s funny, I thought I was going to get the Botox and be able to do all these things I was not able to do prior. That’s not at all what is happening..
It’s a process I guess... I am thinking for some reason around the 6 week mark I should really be able to gauge if i am able to do more. I guess I just think the first 4 weeks are going to be up and down because Botox is a paralytic before it relaxes. My therapist shared with me that one of her patients had Botox and her pain went from a 8 to a 2 and that after a couple of weeks she was doing so great she stopped coming. I just thought that is how it was going to work for me..I don’t know, I guess her patient got really lucky. Good for her! Anyway, I guess I will just have to wait it out and hope for better days soon. Hoping you feel better with time and try to be patient with your progress. I am having a lot of ups and downs as well, so your not alone. Thank you for keeping in touch with me. It is so nice to have someone who understands what you are going through with the Botox and to share your experiences with. I am a week ahead of you( 3 weeks post botox) so I can give you the mental prep Here if you need to talk- Take care
Thanks. Sounds like our experience is not unusual but it’s promising that both our pt’s feel like the muscles are more relaxed! Maybe that means it’s working just fine and the pain needs time to die down like people say.
Not taking any prescription pain stuff. Trying CBD. Ibuprofen doesn’t really touch it. I’ve heard some good things about Cymbalta for nerve pain but would prefer to avoid antidepressants. You have had good experience with Flexeril?
Trying to be patient. It’s just hard to feel like I’m back in the hole after so much progress. But I’ll get back to it. Hopefully the Botox will take me way past it! Here if you need to talk as well. Good vibes and healing thoughts!
Unfortunately I have been on flexeril for about 4 months now. I am sensitive to medicine and do not like to take medicines. I take a 1/4 tablet as needed. I find it very helpful in decreasing the muscle spasms and calming the nerves. Unfortunately it is sedating to me and I am unable to drive if needing to take multiple doses. Again, I am highly sensitive. I have not tried any antidepressants. I am kind of hoping to avoid them if at all possible. I do here cymbalta is very helpful and more of a newer antidepressant for pain then Amitriptyline. I can not imagine you must be getting much pain relief with CBD oil and ibuprofen? I feel bad that no one has offered you a muscle relaxer. Robaxin is another muscle relaxer that is less sedating then flexeril. I prefer it, I just needed something stronger when my pelvic floor went into spasm. Maybe you could ask your PCP or whom ever is treating you for PFD for a muscle relaxer? I just feel that maybe you should have something if your muscles are spasming. You could always take 1/4 of a tablet if you do not like medicine. I would try that first before committing to antidepressant. Well I hope tomorrow is a better day for you. It will get better- Take care.
Hi there! I was just wondering how you have been feeling? I know you were having a couple bad days...Hoping you are feeling better. I just had therapy today, and I am a little sore. The muscles seem to be relaxing more readily, and I do not have as many knots/ trigger points as last week. The more therapy I seem to be getting the better I feel. I was wondering how frequently does your doctor recommend repeating the Botox injections? Some doctors say every 3-4 months and some say every 6. I am hoping not to have to do this again, but I hear it is usually more than once. When you have some time, let me know how things are going with you ok- Take care
Hey, I’m doing alright. Better than before. I had PT today as well so I’m pretty sore but my therapist said the Botox definitely worked. Still gotta go through this a while longer I suppose but she says we’ll get there. The Botox was pitched to me as something we’d probably only do once.
I had to stop the Cymbalta. So far the two antidepressants I’ve tried (Lexapro and Cymbalta) have just made me a jittery, sweaty mess. I’m hoping to beat this without drugs that make me feel insane. Since I still have muscle tone issues, I figure I’ll focus on that. If the pain remains, I guess I’ll have to take another look at drugs to calm down my nervous system.
But I’m doing okay by and large. I believe I’ll get there and working to stay positive mentally. Glad you’re seeing progress, Dem. You’ll get there too!
Hi- Glad to hear you are feeling a little better, and that your physical therapist is seeing a big difference in your muscles. Sorry to hear about the antidepressants...They unfortunately can be really hard to tolerate. I am trying to avoid at all costs myself. I also hear amitriptyline ( older antidepressant) can help with muscle and nerve pain. It is really trial and error with antidepressants. Amitriptyline may have more side effects...it just depends on your biochemistry. So again maybe you could try robaxin( muscle relaxer) or flexeril for muscle spasms. They do not have all the benefits of antidepressants, but they still help to calm the nervous system and to stop the muscle spasms. So this is how robaxin works... it is a muscle relaxer and lasts about 4 hrs in your system short duration not terribly sedating. ( I take 1/4 tablet) Flexeril is much stronger and has a half life of 18 hrs and takes like 5-13 days to clear out of your body. Robaxin clears in about 24 hrs. Flexeril has a similar chemical makeup to a TCA antidepressant. It is off by like 1 bond or something like that. So it failed as an antidepressant, so they marketed it as a muscle relaxer. It is stronger then robaxin, but honestly my robaxin did not touch my pelvic floor muscle spasms and or calm the nerves down. Some people really like Flexeril and say it does not sedate them, it just mellows them out and takes the pain away. I take a 1/4 of a tablet only, and it really helps life some days. I agree that less is best when it comes to medicine, but I just don’t want you to be suffering. These muscle relaxers( robaxin and Flexeril) are not habit forming and there is no withdrawal symptoms like with antidepressants and narcotics. They are not controlled. Soma, I think is the only controlled muscle relaxer?? Anyway, sorry about that!! ( I am a nurse) Flexeril may work well for you to calm the spasms and nerves down. There is someone that posts on health unlock and it has done wonders for her. Just a thought! Thank you for keeping in touch me and updating me on your progress. I am glad to hear you are feeling a little better... The antidepressants not agreeing with you I am sure did not help. I Hope you continue to feel better everyday. Here if you need anything. I will message you sometime soon- take care
Hey, Dem. Just wanted to let you know I’m doing much better. I feel better than at any other point in my recovery. If it’s the Botox, great. But I also know pt has been a huge help. I’m doing more and feeling less pain and discomfort.
I still have a ways to go, but I can finally see my recovery and I’m excited to keep going. Hope you’re well!
Hi -So glad that hear!! I figured the Botox needed to relax a little. I am really happy for you. I unfortunately had a set back last Tuesday... my therapist put my piriformis muscle into spasm. If I remember correctly, did you have Botox administered into your piriformis muscle? If so, how is internal PT treating it vaginally or rectally?
I did get Botox into my piriformis (and levators and obturators). I’m a man so rectally is the only way in, but I think the piriformis is accessed externally by my pt and with stretches. Do you foam roll?
Ok. So my PT was suppose to rectally attempt to smooth out coccygeus muscle, and had done it 2 times the week before. Everything was great the first week, and I felt a huge difference. So on Tuesday I said let’s work the coccygeus muscle vaginally and rectally. She agreed. So after awhile she said I think this is piriformis muscle and just started working on it. Within hrs of leaving, I could tell I was going into spasms, thinking in my rectum. My heart rate will always tell me as it will go into 120’s-130’s. So hear I am in I guess deep piriformis/ rectal spasm. Since last Tuesday. I originally started pelvic PT back in March from an OB-GYN MD putting my pelvic floor into spasm. From March-May I had rectal spasms then they stopped. This does not feel the same, this is deeper. So my question is, is this muscle deep in the rectum? Does your PT address it to help remove trigger points? Thank you for keeping in touch. I was actually going to message you this evening. Again, glad you are feeling better
I do foam roll
I think of the piriformis as being part of the glute area and off to the side, so I don’t expect it to get hit internally. That said, I’ve had plenty of luck directing my pt towards areas of pain or tightness so as long as you’re descriptive, I suspect they can find it and resolve it?
Sorry you’re having an issue (par for the course). But you’re making gains and I’m confident it can and will be resolved.
Thank you for the support, I appreciate it. Please pardon me... but my PT therapist was to the knuckle maybe a little past. She said it was piriformis muscle. About an inch and a half in. Does this seem to deep by chance? So sorry just worried it may have been a deeper muscle into spasm that can not receive any Botox.
I really don’t know the musculature all that well. I do believe every muscle can be treated either with injections or manual release. I suppose its possible to reach the piriformis internally. I’m no expert though. This will resolve though. One way or another. Have you read Pelvic Pain Explained? My favorite book on the subject and it’s taught me a LOT. It was coauthored by the woman who runs the clinic I attend and they definitely know their stuff. Could have helpful info if you’re looking.
No, I have not but thank you for passing it to me. I have heal pelvic pain. A lot of the exercises are to advanced for me at this point. Hopefully some day. Hoping to calm the muscles down soon. I was doing so well the week before, right at the one month mark from my botox procedure. I was Just wondering if you don’t mind.. I am on the East coast, and it was hard to find someone to do pelvic Botox. I actually had to travel to get it. Do you mind telling me the Clinic you went to? I was looking in Ohio, Boston, Maryland, Mayo Clinic, etc..
I go to the Pelvic Health and Rehabilitation Center (pelvicpainrehab.com). I believe they have a clinic near Boston and they are THE BEST. They referred me to a pain doctor they work with in L.A. (where I am) who did the injections via ultrasound. The book I recommended is their book. Good place. Smart people. And they will tell you: you will get better. So many ups and downs to this, Dem. It’s insane. But you’re doing it. Keep going! ❤️
Thank you... I am so grateful to you. I never saw this pelvic group while searching in Boston. I was looking at Mass General. That’s wonderful you had your injections done under ultrasound. That is the way it should be done! Very hard to find anyone doing it that way other then the Mayo Clinic. Good for you! Yes, I agree to many ups and downs with this. I am hoping for better days once again sometime soon. So good to hear you are finally getting some relief and benefit from the Botox. I think you have made it through that waiting period we hear about. Thank you again for passing your pelvic clinic to me as well as the book. I will have to look into the locations near the Boston area a little more. L.A... I love California it is such a beautiful state! Miss the West Coast. I lived out that way years ago. Well I hope you continue to make progress and feel better everyday. I think you are heading in the right direction for sure. Message you sometime soon- Take care.
Hi there! Just thought I would check to see how you are feeling and how things were progressing? I am the same.. I still have the spasms and have been a little down the last few days. I just don’t know if the Botox was to little at 100 units and that’s why my pelvic floor went back into spasm after a month, or if my therapist put some other muscle in my rectum into spasm. I have to call my doctor sometime this week and don’t want to blame the Botox if it is not even a pelvic floor muscle in spasm. Any thoughts?? Anyway, hope you are doing well... Whenever you have some free time, please message me back and let me know how you are doing-Take care.
Hey Dem. I know that autonomic muscles can relax a bit from Botox but still be tight. Such is my situation with the levators. I’m doing okay. It’s a long process, 2 steps forward, 1 step back. I’m resigned to this taking a long time to resolve but I’m better overall than I was a couple of months ago so I’m optimistic this will come to an end, just not as soon as I would like. It’s a marathon alright and progress is nonlinear. But I trust my team so I believe I’ll get there like they say I will. We’re gonna do it!
Hi there! Great to hear that you are feeling better since having the Botox placed. The first month is rough, but happy to hear you feel a definite benefit from it and that it was worth your while. So another friend from health unlock is contemplating Botox, and I have been messaging her while I was deciding if I should have mine. She told me about DCT course recently - David McCoid. I was just wondering if you have ever heard of this or have any feedback on this course? Glad you are well- Take care!
I’m very skeptical about DCT as I haven’t seen any evidence to support it. The truth is pelvic pt is a very long process but I believe it works. I understand looking for something else because of that lengthiness, but I’m sticking with it as it has a proven track record and the experts I’m seeing have had many many patients cured with it.
Yes, the little I looked at the website left me with some questions. I thought I would ask you as I know you have good fund of knowledge on this topic. My friend from the pelvic network is where I learned of DCT. Yes, I agree pelvic PT is the key and takes along time to retrain the muscles. My doctor that placed the Botox actually is not a huge proponent of it. He does it but says it just fast tracks PT. It can not be used in place of PT. I unfortunately have had a few set backs with PT and it is very hard in my area for pelvic PT. There are only a few therapist here and some are months to get into see. We have a couple therapist whom will not accept health insurance and are pay out of pocket. I am currently on an 8 month waiting list to do this. You are very lucky to be in California...I am sure you have a plethora of therapist. Happy for you! Well thank so much for your help. Continue to feel better-Take care.
I’m sorry for the difficulties in getting in to see a pt. It’s unfortunately a costly and time-intensive process, but I believe with the right therapist, a worthwhile one. I’m hoping you can find a way to do it regularly since I really believe in it.
Hi wreckdum- So my friend on health unlock, whom I have been messaging for a few months now has been following people who have had pelvic Botox administered. She is trying to to decide if she would like to move forward with it. I have shared that I had met you and that we were 1 week off our procedures. So she has a male friend and he is having quite a difficult time and is considering Botox himself. She asked if she could speak with you? I have not shared your profile name with her, and will not unless that is ok with you. They both live out on the west coast, and maybe you will know or have heard of each other’s medical doctors? Let me know what your thoughts are on this when you have some free time. Hope you are well- Take care.
Sure, Dem. Your friend can message me. I’ll try to be as helpful as I can.
Hi- Thanks that’s great! Her screen name is kalecolbe12. You may have seen her posts on health unlock. Thanks so much for trying to help her friend. That’s nice of you wreckedum. Take care!
Hi wreckdum! I was just wondering when you had your Botox administered you said they used imaging. Is that to see which muscles are in spasm or is it make sure the Botox is administered into the right location/ muscle? Also just wondering how you are doing? Are you having any muscle spasms or have you been making slow but steady progress? I have been having increased pelvic floor spasms the last two weeks. I unfortunately do not think I had enough Botox into a couple muscles and think I will be needing an increase in Botox and another round of injections. Hope you are well.
Hey Dem. I believe the ultrasound imaging was mainly to make sure the needle entered the right muscle. I suppose it *could* see some tightening/spasm but that wasn’t the intent as far as I understand. I’m doing okay. Slow but steady progress. Haven’t had any debilitating flare-ups since the Botox injections. I still have work ahead of me but I’m at least 50-60% better. I know I can get there. I realize you’re working with the tools at your disposal but I can’t stress how much physical therapy has been key to my recovery. The Botox may have been helpful, but it’s only served to support physical therapy, at least in my case. My muscles are getting stretched in pt as well as relaxed and I think that’s been a key factor in feeling better.
Hi wreckedum- I just wanted to say I am really happy for you... 50-60% better is great!! I could just tell after that first month you had taken a turn for the better. Really happy for you! I forgot to tell you that I ended up going to colorectal MD after that incident a few weeks ago at PT( caused rectal spasm) and he prescribed some cream. I have to say it has worked and calmed things down. So I am hoping to be back on track now. Yes, it would be nice not to have another round of Botox but my muscles were strained pretty bad at PT which is why I ended up having the injections. My stats are a little worse at maybe only 20% better. A couple muscle have been tight since the injections and I am thinking they just never got enough Botox to relax the muscle. I will have to give it some more time and see how things can progress with PT. Well thank you so much for keeping in touch with me wreckedum. I hope that you continue to feel better everyday. I know you will get there too- Take care.