Our care team uses chemodenervation injections to treat children with serious muscle tightness (spasticity). Rehabilitation doctors, who specialize in improving your child’s physical function and comfort, provide chemodenervation injections. They do hundreds of these treatments each year, underscoring our deep expertise in caring for children with muscle spasticity.
Children who need chemodenervation injections may have multiple therapeutic needs. The team of physical therapists, rehabilitation specialists and other experts at Children's Health℠ work together to help your child thrive.
Chemodenervation injections are a treatment designed to relieve spasticity. The care team uses a small needle to inject medication directly into your child’s muscle to improve that muscle’s function and range of motion. This treatment works best when we use it along with physical therapy to help your child move and strengthen their muscles.
Each child responds a little differently to these injections, and they work better for some children than others. Your child’s care team works closely with your child to determine whether chemodenervation injections may be right for them.
Spasticity is a muscle control disorder that causes prolonged muscle contractions and extreme muscle tightness. The condition can interfere with your child’s ability to move and do daily activities, such as getting dressed or brushing their teeth.
Spasticity can occur with a variety of conditions, including:
The two main types of medications we use for chemodenervation injections are:
Key benefits to chemodenervation injections include:
The side effects of chemodenervation injections vary based on the type your child gets.
Most side effects of botulinum toxin injections go away within about two to three days after treatment. Side effects may include:
The main side effect for phenol injections is discomfort at the injection site for one to two days. Because this treatment requires general anesthesia, children may experience side effects from general anesthesia such as nausea or disorientation when waking.
Chemodenervation injections are safe and effective, but they have possible risks, just like any treatment. The risks are rare and temporary, and they may include:
Before we recommend chemodenervation injections, your child will undergo a thorough evaluation, which helps limit the likelihood of these risks. Should they arise, your child’s care team will work with you to navigate them.
First, our team performs a physical exam to confirm that your child needs injections and creates a treatment plan. Next, we will work to confirm coverage with your health insurance company. Then, we will schedule an injection session for your child. This whole visit will take an hour.
We rarely need to put your child under general anesthesia unless they are having phenol injections as well. That means your child can have the injections at an outpatient location and then go home soon after. In most cases, your child may eat, drink, and take any medications they need prior to the injections.
Sometimes, we will give your child an anti-anxiety medication before the injections to help them stay relaxed. If you child needs this medication, our nurses will help guide you on how to prepare your child for the appointment.
We reassess your child over the course of treatment to ensure that the injections are working and adjust them as needed. We also obtain consent from you and your child before we begin.
First, we apply a topical anesthetic to your child’s skin where we plan to insert the needle. Then, we insert the needle into the muscle. Whenever possible, we communicate with your child at every step of the process so there are no surprises.
Sometimes, we use electrical stimulation to help confirm the targeted area for treatment. For some children, this part of the procedure can be uncomfortable but not painful.
After the procedure, you can take your child home right away. If they had anesthesia, you’ll need to stay with them at the clinic until they fully awaken.
Once you take your child home, you can give them ibuprofen or acetaminophen if they experience pain, soreness or aches.
You may want to ask your child’s care team:
Our pediatric rehabilitation specialists have a combined 45 years of experience treating children with all types of movement disorders and conditions. We give these injections frequently and have advanced training in managing spasticity in children of all ages.
Depending on each child’s unique health situation, it may take 3 to 14 days for the injections to take effect.
No. If your child’s pain is manageable in the first few days after the injections, they can go back to their daily routine.