Botox for Stroke Patients: How It Can Help with Spasticity Relief

Is Botox an effective treatment for spasticity after stroke?

Following a stroke, miscommunication between the brain and muscles can cause the muscles to involuntarily contract and become stiff, a condition known as spasticity.  One way to relax the muscles is to use Botox.

Most patients aren’t told exactly how Botox works, so they only see short-term results. This article will show you how to turn your temporary gains from Botox into lasting relief.

Botox for Spasticity After Stroke

Spasticity is a condition where the muscles become stiff due to prolonged muscle contraction after neurological injuries like stroke. Patients may feel like spasticity is a problem with the muscles, but the problem stems from miscommunication between the brain and the muscles.

When a stroke damages the motor cortex, it impairs the brain’s ability to tell the muscles to either contract or relax. This miscommunication can cause multiple muscles to contract at once without being able to relax, causing spasticity.

By injecting Botox directly into the muscles that are affected, spasticity can be significantly reduced. Botox (botulinum toxin A) works as a “nerve block” that blocks the release of chemicals that signal your muscles to tighten. As a result, your muscles relax.

This study found that reduction in spasticity was associated with significant improvement in arm function after stroke. It suggests that a moderate dose of Botox helps reduce spasticity long enough to allow for functional improvements without causing a significant decrease in strength.

However, it’s important to understand that Botox is not a permanent fix. Because it does not address the underlying cause of spasticity, Botox only provides temporary results. Once injected, its effects generally last about 3-6 months. Unless you get another injection, spasticity will return. 

By taking advantage of the reduced muscle tone while using Botox and focusing on the root cause of spasticity (restoring the brain-muscle connection), individuals can achieve long-term spasticity relief.  

In the following section, we’ll address some side effects associated with Botox.

Side Effects of Botox for Stroke Patients

While Botox can be an effective form of spasticity treatment for stroke survivors, there are potential side effects you should be aware of.

Common side effects of Botox include:

  • Soreness
  • Fatigue
  • Nausea
  • Muscle weakness
  • Headache
  • Bruising
  • Joint pain

While general soreness and bruising near the injection site are normal, more serious complications like muscle weakness, difficulties breathing, vision problems, and loss of bladder control warrants immediate medical attention. Call your doctor if you experience these complications after your Botox injection.

In the following section, we’ll discuss how to take advantage of Botox to promote more permanent relief.

How to Maximize the Benefits of Botox for Stroke Patients

Botox becomes a temporary treatment when you don’t use it in conjunction with physical therapy to restore your brain-muscle communication.

It’s kind of like using pain killers for a broken ankle without wearing a cast. The painkillers will make the pain go away, but you aren’t doing anything to heal the root problem.

That’s why it’s important to treat spasticity on both levels: relieve the symptoms temporarily with Botox and cure the root cause long-term by doing rehab exercises.

Using Botox without participating in physical and/or occupational therapy will make the treatment temporary. But if you use the effects of Botox to create an opportunity to exercise, then you can see long-term results.


Recovery after stroke is possible because the brain is can utilize neuroplasticity. Neuroplasticity is the central nervous system’s ability to reorganize itself based on your behaviors. Consistently practicing movements affected by stroke will help promote rewiring of those functions to healthy, undamaged regions of the brain. As a result, those movements will no longer be affected by spasticity.

Botox loosens your muscles so that you can move in the short term, and rehab exercise will reinforce demand and promote neuroadaptive changes in the brain so that you can keep moving in the long term.

I was receiving the maximum dose of Botox in my leg, arm, wrist,  almost $3,000.00 worth every 10 weeks.  However, as I continued to exercise by walking around the neighborhood, using my Ex n' Flex 250, SaeboFlex, SaeboStretch, and a daily program of Electrical Muscle Stimulation, I had cut my Botox injections down to every 4 months, with no Botox in my leg, and only a very slight amount in my wrist and finger flexors.  So exercise plus Electrical Muscle Stimulation works. 

However, in August 2021, I suffered from Vertical which really limited my ability to walk around the neighborhood, then as I was recovering from that, I somehow ended up with a cut on my leg where my Walkaide straps on, so I could not wear it.  If that wasn't bad enough, I twisted my lower back, while putting my pants on, so I am limited to what exercises I can do both outside and inside.  Since my movement has been limited, due to circumstances beyond my control, my Spasticity has once again returned in my ankle, leg and hip flexors.  I am still using the EMS on my hand, arm wrist and shoulder, so my upper body is fine, but I have to get my lower body moving very soon.  Here are pictures of some of the equipment I use to help battle my Spasticity.  Botox helped bridge the gap, and in order to stay off the Botox, I have to recover and stick to my exercise routine.

  Ex N Flex 250              Bike                SaeboStretch  SaeboFlex Phase 5 EMS