Friday, September 20, 2013

Botox Treatment for Facial Pain

So along the many paths you can take on the road to recovery, I've recently wandered down another one- Botox injections. No, I'm not getting a little nip/tuck. I'd heard that Botox can be used for facial pain.

THE BACKSTORY:  My orofacial pain doc recommended Botox early in 2013, but it took me over 6 months to actually go through with it.

Part of my hesitation was that he said Botox could make your cheeks look more hollow - if you have a round face or a few extra pounds, this might be a very desirable side effect! I, however, have very well defined cheekbones and lost a great deal of weight due to stress plus, now that I'm getting older, my face has thinned dramatically. You're going to hate me for this, but, I literally tried to put on a few pounds in preparation for the injections. (My apologies to those who struggle to lose weight; it's in the genes.)

Anyway, I wasn't so sure I wanted to risk changing my appearance, nor to have toxin willingly injected into my face.

So I did my usual research, consulting "Dr. Google," and some of my Facebook friends. Sandy M, in particular mentioned that she'd done very well with the Botox (Thanks, Sandy!). So just a speedy 2 months and 3 cancelled appointments later, I finally mustered the bravery to have the injections yesterday.

Just for context, I was expecting Botox to help with my facial pain - if it could eliminate the tongue tingling too, that'd be a bonus! The pain developed from me tensing/clenching my face unconsciously, as a reaction to the protracted pain of the throbbing teeth and burning tongue. This created a perfect storm of tension in my face that has made the masseter muscle hard as a rock instead of pliable. The primary purpose of the masseter is for chewing. Here's a fun image.

The "medial pterygoid" is where I have chronic pain - it feels like pressure- like someone is pressing down their knuckle very, very hard on that spot, 24x7. Pain radiates to my ear, so that I can't sleep on my left side, rest my head in my hands, or hold a telephone to that side.

When I decide to live on the edge and eat something crunchy or chewy (for that matter, any food not suitable for babies and grandmas,) I am left with even more achiness for days afterward.

Because this is all in close proximity to the lingual and thus trigeminal nerve, it's hard say which came first, the chicken or the inflamed nerve egg but, voila, I now have chronic facial pain. Did I mention how much fun this is?

THE PROCEDURE: There is no prep, no numbing creme or anything, they just go for it: stick, stick, stick, you're done. It was painful for maybe 60 seconds as the Botox went in, and for 30 minutes after I was  sore, but no pain.  (They did not inject in my forehead, unfortunately, so I look just as old as before LOL!)

The neurologist stuck me at the trigger points on cheek in front of the ear. No bleeding, no marks, very small needle.

I think the whole procedure took about a minute, if you don't count all the chit-chat that preceeded it (my doc has a fabulously charming assistant, and I have the overwhelming desire to strike up conversation with anyone to help distract me from matters at hand!)

THE COST - I had to first visit the neurologist ($50 co-pay) for evaluation. His office submitted the request to my insurance company, and after a few weeks they approved coverage. So I'm just paying a $50 co-pay for every Botox visit going forward.

THE RESULT: I'd love to say that, with the Botox, I suddenly am pain-free and look like a Supermodel...but no such luck!

But seriously, the good news is, I look exactly the same...though I realize this could change over time as it takes a few weeks to really settle in. We shall see. I will post again after the toxin has had a chance to really do its stuff.

The pain reduction was noticeable for the first 24 hours. However, I made steak stir-fry for dinner, complete with crunchy veggies. (sigh) Silly, silly girl. Now I'm hurting again.

I don't jump/wince as much when touching the left side of my face and head as I once did, though. I'd say about a 30% improvement on Day 2. From what I hear, pain may lessen more over the course of weeks and months, til the botox finally wears off, and you need the shots again. As for the tongue, real change at this time.

Will post again in a few weeks with an update.


  1. nerve damage symptoms similar to shingles symptoms. Have u gone to a GP and/or tried ELAVIL (low dose)? Got fed up after week 6 so went to GP and seems to help -- not the healing process, but the sleeplessness and nerves from firing on all cylinders!!

  2. Hey, Stacy again.. One more thing, what test can I request to show the extent of damage to my nerve? I would like to know if it is actually severed or not. This will help me make a early decision about surgery. My oral surgeon is not helpful.

  3. good to hear it worked a bit on your cheek jane :)...colonzapam still a lightsaber ...alot of LND is anxiety ..theres always pain in the body ....but anxiety numbness is the shits looking around for more remedies ..GINSENG is one i heard

  4. Hi Jane,

    I hope you had a good Christmas.

    It's been a long time since I posted a comment, and I thought I would just give a short update. It's been three and a half years since my injury. The pain has lessened a lot since the nightmarish early days, but it's still there nevertheless. I've accepted it as something that's going to be part of my life, and I try not to go down the "why me" road too often.

    My oral surgeon has been upfront about the pain. He told me it's probably never going away. When I heard those words, I felt dread, and also a sense of relief. At least he doesn't think the pain is all in my head! As to how the damage came about, he could only guess.

    Anyway, sometimes I get waves of pain, and twinges of weird sensations in other parts of my teeth, parts which are not near the original damaged site. Has it happened to you? According to my OS, since my nerve has been damaged, the transmission of signals to other parts of my teeth have been disrupted, and I may be experiencing strange sensations in other parts of my teeth. Whenever these sensations of pain/weird feelings come on, I panic. They invariably disappear but I'm always terrified of the whole nightmare repeating itself again!

    Do let me know how you are going on. Wishing you a hope-filled New Year,


  5. 3 treatments Auricular Acupuncture has put the Fire Out of my tongue !!! ,i now only have a dull light pain on the left side of my tongue I've been using nurontin 2 600mg twice a day for the rough patch there , i did have burning for a 1 1/2 YEARS THANK GOD its over i will still get more acupuncture treatment and stay on my meds until i can handle it emotionally... there is hope out there keep trying i experimented with herbs and medication ,though the results from them are lightweight , on the other hand acupuncture is proven to relieve sciatica ,a painful back spasm ,thats when i decided to give it a shot .my Dr ken barry from asian therapeutics has given me hope once again ...

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  7. Does this procedure for botox treatment for face will be more painful?

    1. Farida, the Botox treatment was painful for just a second, more like uncomfortable than painful. And, it didn't work for me for more than 24 hours. But, to be honest, I think I had a really crappy doctor. He took no care whatsoever, he was very quick and with no bedside manner. Perhaps you will have better results.

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