Botox for MS Spasticity: My Experience from 2014 to Today, and What Science Says Now

How can Botox help with MS spasticity? My real results, some common myths, and science-backed insights for chronic muscle tightness.

By: Mariska Breland  ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ 

Flashback Blog Post from 2014

I’ve had Botox injected into my calf muscle — twice for MS related pain/spasticity. And… nothing.

“Wait a week or so,” my doctor said.

Still nothing.

Another week?

Nope. Well, maybe it looked a little less cramped? Maybe?

Two weeks later, not only was my calf still tight and painful, but extensor spasticity kicked in. That was new for me, though I’d seen it in others. Now, when I lie on my back and try to straighten my leg, my leg goes wild — straight out, toes pointing, full-on spasm. It feels like a never-ending charley horse. You know, when your foot cramps up, your toes flex and sometimes cross, and the only relief is standing up? That, but all the time.

The weirdest part? I can feel it coming just by thinking about straightening my leg. It also happens the moment I stand up in the morning. If I don’t move slowly, I’m instantly up on my tiptoes.

Failed Treatments

I’ve tried all the first-line treatments. Baclofen and tizanidine? Minimal effect, at least at the doses I’ve taken. Botox? Nada (and I’ve tried all four different types). Physical therapy? My strength and range of motion are better, but the spasticity is worse. Even my doctor and PT are baffled: “That shouldn’t happen.” (For the record, being a medical mystery is way less exciting than it sounds.)

Update 2024-2025

After Botox for migraines actually worked (hallelujah!), I tried a new round of injections for my leg — hamstring, quad, and calf. Results? Hamstring: nothing. Quad: no help. Calf: maybe a tiny improvement as we slowly increased the dose. My current doc uses Xeomin (a type of botulinum toxin with less risk of developing immunity). But I’ve also upped my Baclofen, so who knows what’s actually helping?

Latest Science on Botox for MS Spasticity

Does Botox Work for MS?
Yes, for many people. Botox (and similar neurotoxins like Xeomin and Dysport) is FDA-approved to treat spasticity in MS. It works by blocking nerve signals to overactive muscles, relaxing them and reducing spasms. Recent studies confirm that botulinum toxin type A (BoNT-A) can significantly reduce spasticity and pain in MS patients, sometimes improving quality of life. However, not everyone responds — and for some, like me, the results are underwhelming.

What About Botox Immunity?
About 15% of people who use Botox for spasticity or dystonia for several years develop an immune response, making the treatment less effective. Xeomin is sometimes preferred because it has fewer proteins that can trigger immunity. Ummm, this can even happen for cosmetic dermatology like trying to get rid of those pesky 11s (the rage lines!)

Other Treatment Options

If Botox and oral meds (like baclofen and tizanidine) don’t work, there are other options:

• Other medications: Dantrolene, Valium, Klonopin, Neurontin
• Physical therapy: Still the mainstay for spasticity, focusing on strengthening, stretching, and range of motion. Our classes on The Neuro Studio focus on range of motion through movements that help with spasticity, and our courses like Pilates for Neurological Conditions and Advanced Neuro Techniques both dive deep into spasticity.
• Alternative therapies: Aquatic therapy, relaxation techniques, and braces can help (some people).

For patients, learn about managing MS symptoms like spasticity in the MS Master Plan — there's a LOT of information there. Or join me for a monthly Q&A. Existing member? Log in. Not joined us yet? Find out more.

For practitioners, our workshops Pilates for Neurological Conditions and Advanced Neurological Techniques both cover working with spasticity in depth. It's one of the toughest neuro symptoms (and if you can help figure it out, absolute magic for movers to conquer!)

Final Thoughts

Botox and other neurotoxins can be game-changers for many people with MS spasticity—but not everyone. If you’re like me and the usual treatments don’t cut it, you’re not alone. Keep exploring, keep advocating for yourself, and remember: sometimes being a medical mystery is just part of the journey.