Melissa Juried Kriebel
HOWLAND — After a three-year absence, the Botox Clinic has returned to Hillside Rehabilitation Hospital to deal with chronic migraines and focal spasticity.
Spasticity is a condition in which muscles stiffen or tighten, often as the result of a stroke, cerebral palsy, multiple sclerosis or traumatic brain or spinal cord injury, said Megan Teeples, M.D., a doctor of physical medicine and rehabilitation. She recently came on board at Hillside, reopening the Botox Clinic while replacing the previous doctor, who moved to another practice out of state.
“Botox helps relax that muscle so it’s not so tight,” Teeples said. It unhinges the “catch” that keeps people from being able to, for example, fully bend their arm at the elbow.
There is no cure for spasticity, but a low dose of Botox — the muscle inhibitor botulinum toxin — relaxes muscle fibers, which can temporarily return a good measure of function, she said. If the Botox therapy is successful, the patient will be scheduled for a repeat injection in three months as needed until other therapies can work.
“For migraines, we inject Botox to the neurotransmitters that send pain signals,” Teeples said. Botox blocks the release of chemicals involved in pain transmission, preventing migraines for up to three months, she said.
What the Botox Clinic doesn’t do is cosmetic Botox injections. Botox became popular in the 1990s as a beauty treatment to temporarily smooth out frown lines, crow’s feet and forehead lines.
Teeples said the clinic at Hillside serves only therapeutic purposes – only after other therapies and treatments haven’t been as successful. Referrals are needed from a primary care doctor or physical or occupational therapist, and Botox is used in conjunction with other therapies.
To qualify for migraine treatment, the patient must have at least 15 migraine headaches a month and have tried other medications first with unsatisfactory results.
For strokes, spinal cord injuries or other conditions or injuries that cause muscle tightness, patients need a referral for an evaluation at the clinic.
“It doesn’t mean you’re going to get (Botox),” Teeples said. “Botox is one mechanism (in the treatment toolbox). It’s safe and effective.”
Both the company and medical doctors set standard doses — the lowest possible that can still be effective — to be used for migraine relief, and a scale for doses used for muscle tightness. It does require the use of a needle, but “it’s a very easy and well-tolerated procedure,” she said.
“It’s used in a lot of strokes, a lot of spinal cord injuries,” she said. “Part of why people (locally) haven’t heard of it is I’m new, we haven’t had it for a while, and a lot of people go out of town to get it.”
It’s also a pricey therapy, but usually fully covered by medical insurance, she said. And it’s no longer something area residents have to travel to Pittsburgh or Cleveland to receive.
Teeples also operates a nerve conduction study / electromyography for people suffering from muscle pain, nerve damage, cramping, tingling, numbness or weakness with no known cause. The electromyography stimulates fibers that can cause the foot to drop when walking or carpal tunnel syndrome. It also is useful to help amputees regain function.
A probe similar to an acupuncture needle can be inserted to calm the muscle fibers that are firing all the time, preventing normal function of limbs.
Teeples, 30, is a Chagrin Falls native who earned her medical degree from the Northeast Ohio Medical University in Rootstown. She worked an internship at Summa Health System in Akron and a physical medicine and rehabilitation residency at the University of Toledo Medical Center.
While in med school, “I volunteered at Fresh Air Camp (in Strongsville) for kids with respiratory problems,” she said. “I thought what they did at the camp was so cool and interesting.
“So much of medicine is fixing the problem and getting back to 100 percent. Some people won’t get to 100 percent, but they still wish for improved quality of life.”
That’s when she set her sights on physical medicine and rehabilitation.
Hillside Rehabilitation Hospital, 8747 Squires Lane NE, can be reached at 330-841-3607.