Therapeutic injections: botulinum toxin, trigger points, nerve blocks
When simple steps are not enough: targeted procedures for muscle pain and nerve pain, as part of a treatment plan.
In step-by-step treatment of orofacial pain, injections usually come after simple measures (self-care, exercises, a splint, medication) have been tried and were not enough. We recommend them after a diagnosis, as part of a plan, not as a stand-alone treatment.
Botulinum toxin
Injected into the chewing muscles (masseter, temporalis), botulinum toxin reduces the strength of contraction for a few months. It can be an option for facial muscle pain that doesn’t respond to other treatment and in selected cases of painful bruxism.
- it starts working within a few days and usually lasts 3–4 months
- it doesn’t stop bruxism for good and doesn’t replace the other measures
- its use for orofacial pain is a specialised indication, discussed individually, with its benefits, limits and possible side effects (for example temporary weakness when chewing)
Trigger-point injections
Trigger points are very tender spots in a muscle that refer pain elsewhere (for example from the masseter to the ear or teeth). Injecting them with local anaesthetic can break the pain cycle and make it possible to resume the exercises.
Nerve blocks
A nerve block is an injection of local anaesthetic next to a nerve. It has two roles:
- diagnosis: if the pain goes away for a while after blocking a nerve, we know where it comes from
- treatment: in some nerve pain or headaches (for example an occipital nerve block), it can reduce the pain for a period
Good to know
- the procedures are done in the surgery, with a fine needle, and take a few minutes
- beforehand we ask about your health conditions, medication (including blood thinners), allergies and pregnancy
- afterwards you can usually go back to your normal activities
- the result is reviewed at a check-up, and treatment is repeated only if it helped