 The Clarinet BBoard
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Author: Dan Shusta
Date: 2013-01-25 17:25
Greetings everyone,
I stopped playing clarinet quite some time ago due to embouchure dystonia. Today, I went to my doctor and causally mentioned this problem during our long discussion and my doctor suggested that Botox injections into the muscles on the right side of my mouth might help.
I would like to hear from players who've either had these injections or know of players in their groups who've had this done and how these injections affected their playing.
I've done a search but couldn't find any relevant information.
Thanks!
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Author: Chris P
Date: 2013-01-25 18:01
I honestly don't like the sound of that at all!
What are the long term effects or side effects of botox? Has it been documented or are we only about to find out what problems or harm it can cause?
Former oboe finisher
Howarth of London
1998 - 2010
The opinions I express are my own.
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Author: tictactux ★2017
Date: 2013-01-27 19:40
If Botox works in a way a dentist's injections work, I'd gladly abstain. I'd rather learn some intricate massaging techniques (or maybe even try acupuncture) than being shot at with nerve poison.
I too would be interested in long-term data re Botox use.
--
Ben
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Author: hans
Date: 2013-01-29 04:05
Dan,
I've been getting Botox injections (for migraine headaches) for over 5 years, 2 or 3 times per year.
They are administered by my dermatologist with very fine needles that are not painful. I would not allow anyone else to do it; the first time I tried it they were administered by a neurologist who didn't know what she was doing. She didn't inject correctly so that the only benefit was some temporary forehead wrinkle reduction.
My injection sites do not include any areas that affect embouchure so that I can't speculate on how that could affect playing clarinet. The effects wear off gradually over about 5 months and I have no side effects.
Hans
Post Edited (2013-01-30 03:42)
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Author: Danny Boy
Date: 2013-01-29 17:01
I am not a doctor.
My wife is an oboist who also suffers from severe migraine - her neurologist has suggested botox injections as a treatment, and while she hasn't started the course yet we and the neurologist have had a long discussion about how it may affect her oboe playing.
The only thing that was potentially concerning was the possibility of 'leakage' of the nerve toxin - this has happened in a small number of patients that the said neurologist has treated and caused droopy eyes and in some cases mild throat paralysis.
I'm currently off playing with severe tonsillitis - which has certainly 'paralysed' my throat and I can't imagine playing in this condition.
As for the long term effects of botox - the nature of the treatment is that it's relatively short term. Being a nerve toxin - it kills nerves, but the nerves are extremely effective at growing back. As I understand it, the nerves always go grow back - so if you have one course and it doesn't help you (and as an aside, it's not always effective as a migraine treatment) then you'll be no different than before.
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Author: sdr
Date: 2013-01-29 17:13
Had to jump in here.
Botox is not a neurotoxin. It causes blockade of the neuromuscular junction so motor nerve signals are blocked from reaching their muscle targets. Its effects are temporary --- usually on the order of a few months --- so any treatment is temporary and reversible. Botox is a protein foreign to the human body so it can trigger an immune response so that the patient develops anti-Botox antibodies. Such patients must discontinue use of the drug. Since the effects are temporary, there is little to lose by trying the stuff to see if it helps. In this instance, it may be best to be administered by someone expert in management of facial dystonia rather than someone used to treating forehead wrinkles --- the dosing and location of treatment are likely to be quite different.
-sdr
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Steven D. Rauch, MD
Professor, Dept. of Otology and Laryngology
Harvard Medical School
Assoc. Chief for Education and Academic Affairs
Otolaryngology Dept.
Mass. Eye and Ear Infirmary
Boston, MA 02114
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Author: The_Clarinetist
Date: 2013-01-29 18:59
In case you haven´t tried using softer reeds that is perhaps one option.
Maybe you could try excercising the region by playing more often but for shorter periods.
As botox disrupts the snare-complex presynaptically it results in a functional denervation of the muscle which I imagine would cause the muscle to atrophy, and I don´t think weaker muscles is going to help solve your problem. If exhaustion of the muscle or neuromuscular junction is the cause of your dystonia botox might even be contraindicated, though it might be a matter of dose dependency.
Not to mention the at first glance slightly non intuitively perceived idea of paralyzing a muscle you need. I wouldn´t worry about side effects, however, even though I´m sceptical to the whole idea of botox in that region in conjunction with clarinet playing, it might still be worth a try. Rest assured, it may take time finding a possibly satisfactory result as the half-life is very long and consequently the dose adjustment difficult.
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