• Dr. Naureen Akhtar General Practitioner MBBS,MRCGP,DRCOG

Botox for Knee Pain – An Effective Treatment for Injured Athletes

botox for knee pain

British researchers have discovered a new way to use Botox. People diagnosed with Lateral Patellofemoral Overload Syndrome (LPOS), a condition that affects the muscles of the knee and thigh. It commonly affects cyclists, runners and other athletes. Also called patellofemoral pain sydrome, it is often categorized as an overuse injury. But the more appropriate term is ‘overload’ since the condition can also affect inactive individuals.

Hills, steps and uneven terrain tend to aggravate patellofemoral pain. When LPOS develops, even prolonged sitting can already be painful due to the increase in pressure between the femur and patella during knee flexing.

Symptoms of LPOS include a sharp localized pain and inflammation, which prevents runners, cyclists and athlete from continuing as it takes several day to recover. Experts estimate that one in eight active men and one in five active women have the symptoms of LPOS in varying degree.

Current treatment methods include the use of anti-inflammatory drugs, physiotherapy, steroid injections and if all else fails, surgery. Still, despite all these treatment options, most patients reported reduced activity levels and persistent pain.

Knee pain can wreck even the most dedicated cyclist, making pedalling too painful especially on rough terrains or steep slopes. Although there are many holistic ways to alleviate knee pain, from getting a correct bike fit to stretching, medical treatment is still necessary.

Botox for Knee Pain

That is where Botox for knee pain comes in. Based on a recent study published by the American Journal of Sports Medicine, 45 patients with classified LPOS who failed to recover from conventional therapy were administered with Dysport, a type of Botulinum toxin injection, along with physiotherapy. The researchers noted that the patients had overused tensor fascia muscle in the hips rather than the gluteal muscles at the buttocks.

Researchers found out the reason why physiotherapy was not effective in the past – when the patients were performing exercises intended to ease the pain by strengthening the glutes, the tensor fascia lata muscle was still compensating, which concludes that the exercises have minimal effect.

Subjects first done physiotherapy alone but failed. Next, researchers used Dysport in the hip muscle to relax the tensor fascia lata to push the glute muscles to work harder. The Dysport treatment was followed up with physiotherapy to further strengthen the butt muscles.

Most athletes who participated in the study had exhausted all treatment options and Botox for knee pain was their last resort. Of the patients treated, almost 70 percent remained free of pain for five years after the experiment.
Although the research is an exciting new development for riders suffering from knee pain, it is worth to note that getting proper bike fit, appropriate muscle balance and sufficient recovery time can help your knee pain in control before considering Botox for knee pain.

The Benefits of Botox on Groin Area

Botox on groin

Most people knew Botox as a drug that can eliminate wrinkles and facial lines to bring back youthful appearance. However, Botox can also help those suffering from excessive sweating, a condition known as hyperhidrosis.

Today, more and more people are getting Botox to control excessive sweating. Common areas include armpits, the palm of the hands, sole of the feet and even the scalp. And now, people are also getting Botox injections in their groin area too.

The groin area – the trough running from the hips where the genitals is situated, has folds that trap the belly skin and leg skin. This is the area where people, especially those obese, tend to trap a lot of moisture. The maker of Botox, Allergan, claims the toxin injection can block the nerve signals that stimulate sweat glands.

Excessive sweating in the groin area can cause problems, particularly if you are obese or overweight. People who are obese or overweight often have an overhang on the lower abdomen. For thin individuals, it is not an issue of concern since they would have less overhang of lower belly that can trap moisture or sweat.

Botox on Groin Area

Botox injections done for hyperhidrosis of the armpits is usually done between 4 to 6 months since that is how long Botox lasts. As for Botox on groin area, the coverage is about the same as the armpits. Discomfort that can experienced is minimal. In fact, it is more painful in the face than in groin area as the nerve density in the groin is less than on the face.

The injections of Botox on groin aren’t really big but they spread in multiple tiny injections. The reason for doing this is to fully cover the groin area. If you only inject one or two areas, it will be hard to disperse the medication.

As for the risks, the injections of Botox on groin area is very superficial. There should not be any risk as long as the person performing the procedure knows what he/she is doing. Also, the muscles in the groin area are huge, major muscles so the small amount of Botox administered in this area isn’t going to cause any harm.

One of the biggest benefits of Botox on groin area is that it can reduce the risk of developing fungal or yeast infections. Of course, Botox won’t prevent these infections because what it does is only reduce the wetness or moisture in that area. However, by reducing the moisture of the area and keeping the area drier, there is less chance yeast or fungi develop in the groin area.

9 Most Useful Summer Skincare Tips to Avoid Premature Aging and Skin Damage

premature aging

The heat of summer can be a harmful time for your skin. Too much sun exposure, which causes skin pigmentation, sunburn and skin dehydration, followed by skin-drying office air conditioning can be damaging to your delicate skin cells. Here are some summer skincare tips to keep your skin healthy and prevent premature aging.

Up your sunscreen. Use a fragrance-free and oil-free SPF all over your face and body. Never rely on your daily moisturizer, foundation or even BB cream for sun protection. Use a reliable sunscreen as high as SPF30 during cloudless sunny days.

Moisturize – always. There are times when we’re so busy, we miss out on our eye cream and moisturizer. Even if it’s summer, when the skin produce more sebum, your skin still needs moisture. However, switch to oil-free serums or creams.

Keep your skin cool. This is important, especially if you have sensitive skin. If you are suffering from eczema, rosacea or sensitive skin, keep your skin cool by placing your skincare inside the fridge and avoiding direct sunlight. Steer clear of steam baths and saunas as these can worsen your condition. Heat also causes skin dehydration, making eczema worse and sensitive skin more irritated.

Don’t forget the neck and chest. Your neck and décolletage are often ignored when it comes to skincare. Signs of early aging often appear first in this area without you realizing. As a rule of thumb, always treat your neck and cleavage as an extension of your face and continue application of product from the face to your chest, be it moisturizer, cleanser, toner, mask or exfoliant.

And your hands. Your hands, like your neck and décolletage, are age indicators, so try to apply a rich moisturizer and sunscreen every day and exfoliate a few times a week.

Exfoliate. No matter how much moisturizer you apply to your skin, it will never look radiant without getting rid of dead skin cells. Our skin shed every day, resulting in dull, dry-looking skin, especially when exposed to the sun. Buff away tired cells using rejuvenation treatments to stimulate skin regeneration, leaving skin soft and smooth.

Avoid scrubs with coarse granules. Avoid using body and facial scrubs with coarse granules since they can scratch your delicate skin. Rather, choose an exfoliant with fine silica granules or AHAs that will evenly exfoliate your skin.

Protect your lips. Your lips have no melanin, so they are particularly important to protect. Since they are prone to sun damage, invest on a lip balm that has SPF 15 or higher.

Amp up your antioxidants. Eating antioxidant rich foods can help reduce possible skin damage and premature aging and keep skin healthy. Inflammation is among the major causes of premature aging and skin damage. Eat lots of foods rich in Omega-3 fatty acid and Vitamin C.

What Happens To Your Face as You Age – Facial Aging in Your 20s, 30s and 40s

facial aging

As you age, your skin begins to look and feel different. Apart from that, the actual shape of your face also changes. Find out more about facial aging changes in your 20s, 30s and 40s and what you can do to keep your skin healthy and radiant-looking.

Facial Aging Begins in Your 20s

When you head from being a teenager into young adulthood, you start to lose baby fat. Though the changes are subtle, you start to look more like a woman and less like a girl. You may not believe it but facial aging starts at this phase.

This is the time when very early signs of so-called motor wrinkles – the creases and facial lines related to movement – first appear. Also, if you spend most of your time squinting in front of a computer screen, you may also start to see ‘crow’s feet’ or the tiny lines around the eyes.

Young women should also watch for melasma – a brown hyperpigmentation that appears on the forehead and cheeks, caused by a combination of hormones, sun exposure and pregnancy.

What to Do?

To maintain your youthful glow, avoid the sun if possible and always use sunscreen when you’re outside. How you look in your 40s and beyond will reflect on what you do in your 20s. Applying sunscreen is key.

Start using moisturizers on a regular basis. Dermatologists recommend using retinol-based skin care products.

Facial Aging in Your 30s

This is the decade when you’ll notice your skin is less radiant and appears ‘tired’. You will start to notice deep crow’s feet including past sun damage that may aggravate the appearance of small brown spots. Be prepared for the dreaded 11’s – the parallel lines that emerge between your brows.

Both the 11’s and the nasolabial lines around your mouth will appear during this decade.

What to Do?

Experts suggest to increase usage of retinol products to three to four times a week. Also, this is the time you have to use moisturizers and sunscreens. Chemical peels can eliminate minor imperfections and maintain that ‘youthful glow’. To add, this is the decade to go after those wrinkles with Botox and dermal fillers such as Juvederm and Restylane.

Keep in mind that the best way to make the most of the results and ensure safety is to look for a board-certified plastic surgeon or dermatologist.

Facial Aging in Your 40s

When you reach 40, the facial lines and wrinkles become deeper. Lines around your upper lip – called the purse string muscle – start to appear. Since this area is prominent, it is highly prone to sun damage. If you skipped sunscreen on this area, you will see the aging lines here first.

Be prepared to see more lines and creases on your forehead, eyes plus a more noticeable smile lines.

What to Do?

Consider Botox and dermal fillers at this point if you haven’t tried it on your 30s. You also have to use stronger moisturizers and a night cream. Experts believe that when you sleep, your skin undergoes a natural healing process so skincare products intended for night use are absorbed better and may provide better results.

Dermal Fillers for Acne: Review of Various Filler Products

dermal filler for acne

A recent study discusses the common occurrence of acne vulgaris and look at different types of dermal fillers for acne including temporary, semi-permanent and permanent dermal fillers.

Acne vulgaris is a skin condition that commonly affects adolescents (approximately 80 percent) and often appears at the face, neck and back. Subsequent scarring is a prominent concern among acne sufferers. Acne has been classified into two – atrophic acne and hypertrophic acne. Atrophic acne is more common and is further divided into boxcar, rolling scar and ice pick scar.

A newly adapted treatment for acne scars is the use of temporary, semi-permanent or permanent dermal fillers. A research published by the British Association of Dermatologists studied dermal filler as treatment for acne scars, based on a compilation of previously conducted research.

Selected dermal fillers for acne was compiled for review. Only hyaluronic acid was identified as temporary dermal filler. Under semi-permanent dermal fillers for acne, calcium hydroxylapatite, better known as Radiesse and poly-L-lactic acid with the trade name of Sculptra were included. Under permanent dermal fillers, Aquamid (polyacrylamide), Bellafill (Polymethylmethacrylate), silicone and Bio-Alcamid (polyalkylimide) were listed.

For each filler, a number of researches were organised into groups to identify and describe their findings and aims. The article also identified one of the listed dermal fillers Bellafill (PMMA) as approved by the Food and Drug Administration (FDA) based on results from randomized controlled trial. Also, it was stated that fillers administered topically may need laser assistance at some point.

The article concluded that while dermal fillers are commonly used for tissue augmentation, they are not fully utilized when it comes to the treatment of acne scars. The FDA-approved dermal filler for acne Bellafill yielded strong results during a randomized controlled trial. The research focuses to the indication that fillers are effective for the treatment of boxcar and rolling atrophic acne scars. The article added that efficient use may be associated to the length of action of the treatment.

While the article doesn’t introduce new research, it successfully compiled pre-existing data and gives a convincing conclusion supporting dermal filler treatment for atrophic acne scars. With the increasing regard for skin care and treatment, dermatologists may be able to suggest dermal fillers as treatment options for acne scars.

Today, there is a variety of treatment options available that can be prescribed to match a wide range of skin conditions and types, providing options that meet the needs of the patient. Further research on dermal fillers can probably lead to FDA approval to expand options for patients and this emerging area of the pharmaceutical industry.

Recent Study: Stomach Botox for Weight Loss

botox for weight loss

A new use of Botox is now being considered by many doctors – the injectable toxin may help overweight and obese people shed weight, based on early research.

Botox treatment is believed to work by blocking a crucial nerve in the stomach that regulates feeling of satiety and hunger. In a small study in Norway, researchers injected Botox into the stomach of 20 obese individuals, with body mass indexes ranging from 35 to 44. The study utilized an endoscope, a medical instrument to look inside the stomach and administer Botox for weight loss into the lower part of the organ. Participants received Botox at the beginning of the study and then another one every six months.

After a year (patients had received two injections) results revealed that 70 percent of the group had lost weight, with an average weight loss of 17 percent out of their excess weight body. After 18 months (patients got three injections), 75 percent of the patients lost weight, with an average weight loss of 28 percent of their excess body weight.

Researchers emphasized that despite the small size of the study and the need for more research in order to confirm, if future studies validate the findings, then this procedure may become ‘the latest method in treating obesity.
A number of past studies have also tested Botox for weight loss, but majority of the studies found that Botox did not help the subjects lose weight. The difference between this study and those in the past is that earlier studies followed patients for just a few months after a single shot of Botox, whereas this new study followed the patients for over a year with repeated injections of Botox.

Furthermore, researchers in the earlier studies thought that Botox would only help people lose weight since it could slow down the rate of stomach emptying. However, the researchers in the new study had a different theory – Botox can block the vagus nerve – a nerve connecting the stomach and the brain, controlling feeling of satiety and hunger.

The researchers first tested their theory in animals, targeting the vagus nerve with Botox injection in mice and discovered that the rats lost weight by eating less. But in experiments where the vagus nerve had been cut, they did not lost weight even with Botox injections. This experiment suggested that Botox acted through the vagus nerve, inducing weight loss. This made the researchers target vagus nerve with Botox.

Botox for weight loss is relatively safe and patients didn’t experience any serious side effects. Also, the procedure is quick, which only takes about 15 minutes. Still, Botox can cause serious side effects such as trouble breathing, muscle weakness and double vision, in rare cases.

The study was funded by the European Commission and The Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology.

Getting Botox for Career – How Cosmetic Injections Help More Men Compete Against Younger Men

Botox for career

Today, more and more men are jumping on the Botox bandwagon – and they are giving all different reasons to give wrinkle injection a try. According to a recent survey done by the American Society for Aesthetic Plastic Surgery (ASAPS), there is a significant increase in the number of total procedures (9.9 per cent) for both men and women, with more than 400,000 male patients who got Botox injections last year.

Plastic surgeons are not surprised to see more men in their practices. The main motivation of men to get Botox injection is to appear youthful, particularly at work where they’re more likely to face age discrimination. Many men view the procedure as a way to defy aging effectively and freeze time.

The pressure to look young and feel more youthful are not exclusive to women; men too feel pressured. This is according to most physicians who told patients age 35 to 65 years were interested in getting the injection.
The president of the ASAPS Dr. Daniel Mills said, “’They’re simply having more procedures done because they want to maintain the competitiveness in an increasingly ageist workplace”. Nowadays, the younger you look, the better chance you have in competing and staying in market. The most common areas injected with Botox for career are around the eyes and eyebrows.

In addition, spouses and significant others play a part in convincing their partner to go inside their doctor’s office. Some patients feel more comfortable having the procedure after finding out that a loved one or a friend have it, while others just reported that their partner demanded they get Botox.

After seeing more and more men considering this cosmetic procedure, doctors are beginning to pay more attention to men’s aesthetics, as this trend may continue and even perpetuate. In the past, a man checking a plastic surgery website may see procedures often aimed at women. But now, more and more websites are dedicated to cater men.
Another reason to the rise on the number of men getting Botox is social media and the desire to look great on their dating profile. This inspired more and more men to try the Botox.

Most men who likely get Botox for career have higher incomes and a lot of them work in fashion, art, corporate world and law. There’s also no specific ethnicity – Asian, White, African-American.

Studies Suggest – Botox for Arthritis Pain

Botox for arthritis pain

Popularly used to smoothen fine lines and reduce the appearance of wrinkles, experts are exploring the potential of Botox for arthritis pain, specifically rotator cuff arthropathy. Rotator cuff consists of four tendons and four muscles that surround the joints and provide important function. It makes sure the end of the humerus stays within the socket of the shoulder.

Rotator cuff tears are more common among the elderly. This is often caused by wear and tear in the joints and affects up to one in four people. Along with reduced blood supply, tendons in the area become weaker with age. Shoulder blade rubs against these tendons, causing tears in the tissue and impairing movement. Some elderly people experience difficulty in raising their arm above their head due to rotator cuff arthropathy.

Benefits of Botox for Arthritis Pain

In the past, treatment options for arthritis pain include heat or ice packs, anti-inflammatory medications and physiotherapy, and sometimes, for severe cases, surgery. Administration of Botox in the affected muscles bypasses such measures because Botox relaxes the tissue by blocking signals that prompt the muscle to tighten.

Another reason is that Botox for arthritis pain can paralyze the nerves. Similar to injecting wrinkles, it could have similar effect on the muscles that is transmitting pain. The toxin may eventually be used for treating osteoarthritis patients and those with rotator cuff arthropathy, whose pain isn’t adequately controlled by traditional medicines such as analgesics or NSAIDS.

Botox Blocks Pain Signals

Like how Botox flattens wrinkles, the substance can block neuromuscular junction, so the nerve cannot transmit signals, preventing muscle contraction.

In a study published by the Journal of Rheumatology, 54 patients with chronic knee pain were grouped into two – one group were injected with Botox while the other were given placebo. Result of the study showed 71 percent of those administered with Botox achieved significant reduction in pain, with measurable improvement in the joint function compared to 35 percent of those who got placebo.

Botox as a Possible Treatment for Inflammation

Another study has further raised interest by telling that Botox might be used someday for treating inflammation. Published in the Biochemistry Journal in 2011, it cited a future use of Botox – treating chronic inflammation and not only temporarily relieving pain.

The study led by Felix Yeh, PhD said the focus of the study is to learn how the toxin get into the neurons, something he names ‘the Trojan horse strategy’. With the use of Botulinum toxin Type B, a relatively new product, Yeh revealed that the neurotoxin can be used to inhibit the release of tumor necrosis factor alpha, a type of cytokine that possibly causes inflammation in autoimmune diseases such as rheumatoid arthritis.

Recent Study: Botox for Burning Mouth Syndrome

burning mouth syndrome

A recent study has found that Botox injections might be a safe, effective and long-term treatment for ‘Burning Mouth Sydrome’.

What is Burning Mouth Syndrome?

Burning mouth syndrome is characterized by a burning pain in the mouth, occurring every day for several months or even longer. Dentists and doctors don’t have a particular test to diagnosed BMS, hence it is difficult to diagnose. There are no specific treatment that work for the general public, but your doctor may prescribe medications to help manage dry mouth, mouth pain and other symptoms.

The primary symptom of burning mouth syndrome is the mouth pain that is tingling, scalding or burning. There may also be a feeling of numbness. Other symptoms include altered taste in the mouth and dry mouth.

BMS pain may last for months to years. Often, the tongue is affected, however, it may also be at the roof of the mouth, throughout the mouth or only the lips. Some people feel pain every day and others experience increasing pain throughout the day. For most, the pain is reduced when drinking or eating.

Several medical conditions can cause BMS:

  • Allergies
  • Drug side effects
  • Thyroid issues
  • Damage to nerves that control taste and pain

Botox for Burning Mouth Syndrome

Botox has long been used to smoothen wrinkles but it may also come to the rescue for those suffering from a painful condition known as burning mouth syndrome.

A team of Italian researchers found that Botox might be an effective, safe and long-lasting treatment for the disorder. Published in the Annals of Internal Medicine, a team led by Domenico Restivo, MD, of Garibaldi Hospital, Catania claims that Botox, a purified polypeptide that can relax muscles by blocking neuro-muscular junction (nerve receptors) that innervate the muscles, might help ease the condition.

The small study involved one man and three women in their 60s and 70s. All are diagnosed with Burning Mouth Syndrome on their lower lip and tongue for at least six months. Each patient got a total dose of 16 injection in the lower lip and tongue.

The Botox group reported that pain disappeared within 48 hours in all patients. The beneficial effect lasted for 16 weeks after the Botox therapy in all except for one patient whom the effect lasted for 20 weeks.

The other group involving two patients received saline injections as placebo and saw no improvement in their condition. This effectively ruled out the placebo effect. No side effects were noted from the treatment. Dr. Restivo’s team concluded that the positive results from this study is encouraging, believing that the findings must lead to a more comprehensive, randomised trial.

The Benefits of Botox for Neurological Disorders

Botox for neurological disorders

Over the years, the use of Botox has extended, from medicinal to cosmetic. Developed as a biological weapon, numerous studies have revealed its effectiveness and usefulness beyond enhancing your facial features. Right now, Botox has been highly useful in multidisciplinary fields such as urology, endocrinology, ophthalmology, endocrinology and neurology. This neurotoxin provided benefits for many chronic conditions such as muscle spasm and stiffness by relaxing abnormal muscle contractions.

When there are problems concerning muscle activity, Botox has been a go-to drug due to its effect that help release stiffness.

Below are the different conditions using Botox for neurological disorders:

  • Blepharospasm – a neurological condition manifested by forcible closure of eyelids or abnormal twitching of eyelashes and eyelid. In the case of blepharospasm, the eye muscles contract to the point that the person could not open his eyes and they have to use their hands to open them. Such condition can be an unpleasant experience for the sufferer. A very minimal dose of Botox can be administered through a fine needle in the eyelids.
  • Hemifacial Spasm – a condition when there is involuntary muscle contractions of the face on one side, manifested by flickering movement of the affected muscles. The condition can be resolved by injecting Botox on the lower face and around the eye.
  • Meige’s Syndrome – a condition in which the upper and lower part of the facial muscle contracts.
  • Cervical dystonia – a condition characterized by high muscle tone in the neck, resulting in different positions of the head. Sometimes, the neck rotates and pulls in a certain direction. The condition is sometimes called ‘wry neck’ or torticollis. Botox helps by providing controlled relaxation of the affected muscles.
  • Upper and lower limb spasticity – there are times when a person recovers from stroke, muscle stiffness can hinder recovery. In some cases, spasticity is severe that it causes restrictions of movement. Botox help relax the muscles to assist physiotherapy.
  • Writer’s Cramp – a condition in which a person have difficulty in writing only. A person with writer’s cramp may only write one to two pages and after that, their hands begins to give up.
  • Migraine – not all cases of migraine require Botox injection. Botox can be used for migraine if the person experience frequent headaches and failed to respond with other treatment.
  • Botox for Neurological Disorders – How It Work

    Botox for neurological disorders causes a controlled relaxation with abnormal muscle movements or spasticity. The process is ‘irreversible’ and has to be injected every 3 to 6 months. Botox can be highly effective when injected in the right spot. It is important to hire someone with considerable experience and expertise in Botox injection