How Botox helps Ukrainian soldiers who lost limbs in the war

Here’s one way to think outside of “toxins.”

Botox is a trade name for a purified form of botulinum toxin A, a protein that temporarily paralyzes muscles by blocking the nerve signals that cause them to contract.

Injections are used in everything from Smoothing wrinkles To relieve Chronic migraine And relax Overactive bladder muscles.

Doctors at Northwestern University and Ukrainian doctors have now identified another potential use for Botox: relieving devastating phantom limb pain in Amputees in the Ukrainian war.

“Our results show that botulinum toxin can be a powerful short-term tool for the treatment of post-amputation pain when used in conjunction with comprehensive medical and surgical care,” said Dr. Roman Smolenets, anesthesiologist and intensivist at the Multispecialty Clinical Hospital for Emergency and Intensive Care in Lviv, Ukraine.

“This could be another step toward helping amputees live with less pain and more dignity.”

Pain management after amputation

Estimates indicate Tens of thousands of Ukrainian soldiers and civilians have lost limbs since the start of the large-scale Russian invasion in 2022.

Most amputees experience phantom limb pain — pain in the missing limb — and residual limb pain — pain in the remaining part of the limb.

The pain of an amputated limb often requires a multi-pronged strategy. Surgery is used to treat underlying nerve problems. Medications can control pain signals, while physical therapy can improve strength and function.

The study authors wanted to see how well botulinum toxin worked as an approach.

Doctors treated 160 amputees in two hospitals in western Ukraine from 2022 to 2024.

About 20% of them received botulinum toxin injections around painful nerve endings, along with medical and physical therapy. The remaining participants simply underwent medical and surgical treatment.

How can Botox help?

The researchers found that the Botox group improved their phantom limb pain by an average of 40% after one month, while the other participants reported only a 10% increase.

Overall, 69% of botulinum toxin patients experienced at least a 30% reduction in phantom limb pain compared with 43% of their peers in the control group.

Dr. Steven P. CohenThe only side effect of Botox is temporary pain, a professor of anesthesiology and vice chair of research and pain medicine at Northwestern University Feinberg School of Medicine told The Post.

Unfortunately, the positive effects of Botox were fleeting.

After three months, the botulinum toxin recipients were slower than the other group in pain relief, which makes sense because the effects of Botox tend to wear off after three or four months.

It is unclear whether repeat injections can provide long-term benefits. The team of doctors hopes that this will be the subject of future study, in addition to experimenting with dosage amounts and patient selection criteria.

“The next study follows people for one year, separates residual limb pain from phantom limb pain and sees how it relates to anxiety, depression and quality of life,” said Cohen, a retired US Army colonel who served four overseas tours in support of military operations.

What’s next for amputees?

The results were published Tuesday in the journal Archives of Physical Medicine and Rehabilitationmay ultimately benefit the more than 2 million Americans He is believed to have lost his limbs.

Smolenets and Cohen noted that Botox treatments have helped some amputees better use their prosthetics and get around.

The couple attributes the short-term pain relief to the way the Botox was injected.

Botox is usually infused into muscles, but researchers injected the toxic substance directly around nerve endings and the surrounding soft tissue to calm nerve activity and reduce local inflammation.

This technique may help relieve other forms of nerve pain, such as shingles and carpal tunnel syndrome.

As the Ukrainian war continues, Smolenets and Cohen are also testing new wartime treatments for traumatic brain injury and post-traumatic stress disorder.