Neck Pain and Botox Injections

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Presenting Complaint

The patient presented with chronic neck pain of more than 6 years duration. The pain was mainly one-sided, with radiation to the shoulder blade. The patient also experienced significant headaches from neck pain. She was unable to carry on with her job in the retail sector. She was very low in her mood because of the intensity of her pain.

Previous Investigations/Treatments

The patient had seen various specialists in the past including physiotherapists, osteopaths, chiropractors and the musculoskeletal team. She was investigated with an MRI scan which showed degenerative changes in the discs and osteoarthritis in the little joints of the neck (Cervical facet joints).

The patient was taking a cocktail of medications including Amitriptyline, Co-codamol, Tramadol, and Paracetamol without benefit.

Treatment from DR. Krishna at Pain Spa

The patient saw Dr. Krishna at his private clinic in Bristol, desperate for treatment of her neck pain. Dr. Krishna felt that the pain was mainly myofascial and offered trigger point injections with Botox under real-time ultrasound guidance, targeting the trapezius muscles in the neck.

The patient had an excellent response to Botox trigger point injections and was almost completely pain-free within a week.


At the follow-up appointment 4 months after the injection, the patient reported continued benefit from the Botox injections. Her mood was much better and she was back to work. She cut down on her pain killers significantly and had not seen her GP for several months now.

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