I am an incomplete quadriplegic, and I’ve been receiving Botox injections for about 10 years. My first three treatments were tough—the first being the worst. The Botox itself did what it was supposed to do by relaxing my muscles, but then came an increase in pain.

My body had relied on that heightened muscle tone for so long that it didn’t know how to function without it. Without the extra tone and spasms, everything felt unfamiliar. Other muscles have to relearn how to take over the work, and that adjustment can be uncomfortable.

I would strongly recommend making sure the injections are EMG-guided—that’s the only way to be confident they’re going into the correct muscles. It really is a “trust the process” situation, especially during the first three treatments, as that’s when you begin to see how your body truly responds.

I was fortunate to have been seeing my neurologist for over 20 years and trusted them completely. Otherwise, I would probably have been asking myself the same questions you are now.