Botulinum neurotoxin therapy offers a breakthrough in treatment of multiple musculoskeletal and neurological conditions.

Botulinum neurotoxin is derived from a bacteria produced toxin. This toxin is purified and diluted to the point of being extremely safe. This versatile medication has been used safely for years in neurological disorders such as cerebral palsy, blephrospasm and cervical dystonia. In the last 10 years the understanding of the mechanisms of pain has grown tremendously and with it the application of Botulinum toxin.

Dr. Kaplan received extensive residency training in Botulinum toxin use in neurological disorders and has in the last three years became an expert and one of the few doctors in Buffalo who utilizes the medication for treatment of a multitude of disorders.

Dr. Kaplan combines extensive knowledge of muscle anatomy and function with electrodiagnostic skills to precisely place the medicine in the target muscles. State of the art physical therapy is then utilized to retrain and reverse muscle imbalances that frequently lead to various painful musculoskeletal disorders.

These disorders include:

Chronic migraine and daily headaches:

Evidence for Botulinum toxin efficacy  is growing. A most recent prospective placebo controlled multicenter study of 250 patients showed a 50% reduction in symptoms in the group that received the medication. Personal experience at Buffalo Spine and Sports shows an even greater percent improvement.

Benefits of the Botulinum toxin have been shown to increase after three sequential applications, each three months apart. To be considered for this procedure, candidates need to have tried standard oral migraine prophylaxis medications first.

Chronic neck and low back pain: Chronic muscle pain after trauma such as seen in work injuries and motor vehicle accidents or in association with cervical and lumbar fusions has been shown to benefit from intramuscular injection of Botulinum toxin

Patients are considered for this procedure only after an extensive trial of physical therapy and rehabilitation.

Piriformis Syndrome: This is either a stand-alone painful condition of an overactive buttock muscle or is found in conjunction with a lumbar disc herniation and resulting lumbar nerve root irritation.

Several studies have shown a significant benefit of Botulinum toxin injection into the piriformis muscle. Personal experience has been extremely favorable for this condition.

Cerebral Palsy with spastic hemi or monoplegia:

Botulinum toxin has been proven to be very effective in improving ambulation, hygiene, and fine motors skills.

Spastic limb hemi or monoplegia associated with spinal cord injury, traumatic brain injury or stroke:

Here also, Botulinum toxin effective in improving ambulation, hygiene, and fine motors skills.

Pelvic floor pain and dysfunction: This is an exiting new area where the use of Botulinum toxin has shown significant promise. Treatment of pelvic pain requires a team approach.

At Buffalo Spine Sports Institute, pelvic pain specialist Dr. Debra Bergfeld teams up with Jeniffer Aloian, a  physical therapist specializing in pelvic pain to tackle this difficult problem. With their input, dysfunctional pelvic muscles are identified and then localized using electrodiagnostic guidance. Botulinum toxin can then be injected to decrease their activity and thereby allow training and activation of dormant vital pelvic muscles.

Tempanomandibular and orofacial disorders/dystonias:

Botulinum toxin is used to relax key overactive orofacial muscles. This allows for better tolerance of physical therapy and utilization of therapeutic prosthetic devices. Treatment for these conditions is frequently done as a team approach with an Orthodontist specializing in tempanomandibular disorders.