Understanding the condition
What cervical dystonia is
Cervical dystonia, also called spasmodic torticollis, is a condition in which neck muscles tighten or move on their own, out of your control. It most often starts in midlife and usually comes on slowly.
Symptoms vary from person to person. They may include:
- the head turning, tilting or pulling forward or back;
- neck pain, which can spread to the shoulders;
- jerking or shaking movements of the head;
- one shoulder raised higher than the other.
Symptoms can be uncomfortable and can make daily tasks, such as driving or reading, harder.
How it works
How Botox for cervical dystonia works
Botox (onabotulinumtoxinA) is a prescription medicine that is approved by the U.S. Food and Drug Administration (FDA) to treat cervical dystonia in adults. It aims to reduce how severe the abnormal head position and the neck pain are.
The medicine is injected into the neck and shoulder muscles that are tightening. It blocks some of the signals that tell those muscles to contract, which can help them relax. Your provider chooses the muscles and the dose based on your exam and how your head is pulled.
Botox is one part of a care plan for cervical dystonia. Your provider can talk with you about how it fits with your other treatments.
Who may benefit
Who may be a candidate for Botox for cervical dystonia
You may be a candidate if you are an adult with cervical dystonia that causes neck pain or an abnormal head position. Your provider will look at your history, examine your head and neck and talk with you about whether Botox makes sense. Our providers can evaluate you for cervical dystonia, and they also treat people who were diagnosed elsewhere, such as by a neurologist.
Tell your provider if you have had a reaction to any botulinum toxin product, have a muscle or nerve condition, already have trouble swallowing or breathing, or are pregnant or breastfeeding.
What to expect
What to expect at a Botox treatment visit
Before your treatment
You will meet with your provider to review your symptoms, your medicines and any allergies, and to look at how your head and neck move. Your team will tell you how to prepare and will handle any prior authorization your insurance plan needs.
During the treatment
Your provider gives injections with a fine needle into the neck and shoulder muscles chosen for you. You may feel a brief sting with each one. The injections usually take 30 minutes or less.
After your treatment
You can usually go back to your normal activities the same day. You may have soreness or bruising where the needle went in. Treatments are usually repeated no more often than about every 12 weeks, as your provider recommends, and the plan may be adjusted at each visit.
Keep taking your other medicines unless the clinician who prescribes them tells you otherwise.
Benefits and limitations
Possible benefits and limitations
The goal of Botox for cervical dystonia is less neck pain and a more comfortable head position, so daily tasks are easier.
People vary a lot. Some notice a change within a few days to a couple of weeks, and the effect wears off over time, often after a few months; how much it helps and how long it lasts varies from person to person. Some people do not get the relief they hoped for, and the dose or the muscles treated may be adjusted at later visits.
Risks and side effects
Risks and side effects of Botox for cervical dystonia
Common side effects include trouble swallowing, neck pain, neck weakness, soreness where the needle went in, headache and cold-like symptoms. Trouble swallowing is one of the more common side effects when Botox is given in the neck. It is usually mild, but it can be serious.
Rarely, the medicine can spread beyond the injection area and affect other muscles, causing serious problems with swallowing or breathing. Botox carries an FDA warning about this.
Please talk with your provider about the risks that apply to you before deciding.
When to seek emergency care
Call 911 or get emergency care right away if, in the weeks after a treatment, you have trouble swallowing, breathing or speaking, muscle weakness all over your body, double or blurred vision, or a change or loss of your voice.
Common questions
Questions about Botox for cervical dystonia
Your provider can talk through your own plan at your visit.
What is cervical dystonia?
Cervical dystonia, also called spasmodic torticollis, is a condition in which neck muscles tighten or move on their own. It can turn, tilt or pull the head out of position and often causes neck pain. It most often starts in midlife.
How does Botox help cervical dystonia?
Botox is injected into the neck and shoulder muscles that are tightening. It blocks some of the signals that make those muscles contract, which aims to ease neck pain and improve the head position. It is FDA-approved for cervical dystonia in adults.
How long does Botox for cervical dystonia last?
It varies. Many people notice a change within a few days to a couple of weeks, and the effect often wears off after a few months. Treatments are usually repeated no more often than about every 12 weeks, as your provider recommends.
What are the side effects of Botox for cervical dystonia?
Common side effects include trouble swallowing, neck pain or weakness, soreness where the needle went in and headache. Rarely, the medicine can spread and cause serious trouble swallowing, breathing or speaking, which needs emergency care. Your provider will go over the risks that apply to you.
Is Botox for cervical dystonia covered by insurance?
Coverage depends on your plan, and some plans need a prior authorization before treatment. Our team handles prior authorization requests with your plan.
Clinical references
Individual results are not guaranteed and may vary from person to person. This page shares general information. It is not medical advice and does not replace a visit with a qualified clinician.