Neurotoxins (Botox/Dysport)

Neurotoxins may be used to treat a number of different conditions including spasticity, cervical dystonia, and migraine headaches.

Cervical dystonia refers to the tightening of muscles in the neck such that it limits the neck’s range of motion. The most common presenting symptom is neck pain. When mild to moderate, patients may notice that they cannot turn their heads as well. Most patients notice this in particular when driving and needing to look over their shoulder to change lanes. If symptoms progress, the head can become fixed in a tilted position.

When this occurs, botulinum toxin can be used to relax the tight muscles that are restricting the range of motion and also alleviate pain. Dr. Janerich uses EMG guidance to ensure correct needle placement within the tight muscles. The injections are very well tolerated by patients and often little to no pain is experienced during the injections. After the injection occurs, the medication can take up to 14 days to begin working and it can last up to 90 days. Therefore, injections are repeated every 90 days to maintain results.

Botox is FDA approved for Migraine headache prevention. Migraine headaches can be quite debilitating and affect a patient’s ability to function. If a patient is suffering from more than 15 migraine headaches a month and has not responded to other oral medications used to treat migraines, Botox may be considered. The goal of using Botox to prevent migraine headaches is to decrease the number of headaches the patient has per month, decrease the length of time each headache lasts, and also decrease the severity of pain associated with each migraine. It may take up to three injections for Botox to reach maximum benefit, but many patients begin experiencing relief after the first set of Botox injections. Botox can last 90 days and injections are repeated every 3 months to maintain results. If you are wondering if Botox is right for you, schedule an appointment at Janerich Pain Specialists today.

Dr. David Janerich has specialized fellowship training in neurotoxins for the treatment of spasticity, cervical dystonia, and migraine headaches. He completed a fellowship after his residency specifically to learn about these conditions and how botulinum toxin can be used to help treat each patient’s individual needs.


Don't Let Pain Hold
You Back Any Longer

Real Clients...Real Stories

I was recently referred to Dr. Janerich by my podiatrist regarding chronic pain in my knees that I have suffered from for years due to osteoarthritis. I have had pain in my knees since I was 38 years old; I am now 65.

I have tried a multitude of treatments. Among them: Laser treatments, physical therapy, Synvisc injections by an Orthopedic doctor, acupuncture and serious pain pills, along with hundreds of dollars of supplements that promised to turn me into Wonder Woman. [That never happened] No former treatments ever gave me any long-lasting relief. When I saw Dr. Janerich, he gave me something I hadn't experienced in years, "HOPE".

He offered me a nerve block procedure to ease my pain and other options for longer term relief. He was patient and thorough. I never knew there was a bridge treatment between the Synvisc injections and total knee replacements.

So far, the nerve block has been working like a miracle. I may never run a marathon, but I feel so much better. My outlook is positive and I am sure glad I went for this treatment.

Dr. Janerich's staff is friendly and personable. I would recommend anyone to come to this office for pain relief.

— Alice

Approximately 20 years ago, I had a work related injury that resulted in serious injury to both my upper and lower back also affecting my legs. There have been many times that the pain in my legs was so severe that I didn't even think they would hold me up.

After endless visits to chiropractors, acupuncturists and physical therapists I still ended up with limited or no relief. In some cases it actually made my pain worse.

I went to see two surgeons from The University of Philadelphia who told me that I would need several surgery's and even if everything went perfectly I would still only have about 50% relief. They told me that we all have our crosses in life to bear and that I should consider this mine. They felt the risk and recovery from multiple surgery's would not be worth any minimal reward. I was so discouraged and resolved to the fact that there was no choice but to live with this debilitating pain. I didn't want to take pain killers as they would only mask the pain for a short time and I would just have to keep taking them. This was not an option for me. I took Tylenol and tried to aggravate my back as little as possible.

Anyone who has a back injury or chronic pain knows exactly what I'm talking about. You still have to live your daily life in spite of it. I became very depressed believing that this was just how it was going to be.

About three months ago, I began treatment with Dr. David Janerich. He introduced me to new options and procedures which aren't regularly practiced or even recognized in our area that might help with my chronic pain. I figured, what do I have to lose.

After several injection treatments, for the first time in 20+ years I finally have received considerable relief. I am able to perform my normal daily functions with little to no pain. Things that people normally take for granted were now possible. My leg pain is totally gone
now and any back pain I have is minimal. I never thought that this would have been possible for me.

His entire staff have been great. They handled all necessary paperwork and pre-authorizations from the insurance company. They are all compassionate and truly care about their patients.

Dr. Janerich's dedication in helping his patients obtain a life without severe chronic pain is second to none. I would highly recommend that anyone who was in my condition give him the opportunity to use these same procedures and change their lives as well.