Laurence Badgley, M.D. Profile picture
Sep 25, 2020 25 tweets 5 min read Read on X
BOTOX: A PRINCIPLE OF MEDICAL DIAGNOSIS & THERAPY? Several insidious medical disorders encompass similar pathophysiology seeming amenable to #Botox therapy: #Migraine, #TMJ, chronic neck pain (#cervicalgia), & Thoracic Outlet Syndrome (#TOS).
The pathophysiology found within all these disorders is the phenomenon of “crossed muscle” syndromes. Dr. Victor Janda is possibly first to describe this curious syndrome, which is easily discovered by simple physical examinations.
When the body musculoskeletal tower is asymmetric (tilted) within the ambient gravitational field, muscle pairs symmetric from side to side or which oppose in individual body part functions, become dissimilar in dynamic action; one muscle stronger & hypertrophic. The other weak.
For each of the pathologies, I have one or more extended essays in my library of threadreaders. The ideas expressed herein are my own novel findings; based on years of independent clinical medical research.
Within this current essay, I merely summarize the pathophysiologies that I have discussed at length in my several threadreaders.
Many of these findings were first made in women with Hypermobility Syndrome & who are particularly subject to the chronic injurious force that gravity imposes on musculoskeletal towers of lesser stiffness; due to widespread loose joints from inherited connective tissue variations
It is no coincidence that Fibromyalgia is highly associated with Hypermobility Syndrome & that Migraine, TMJ, chronic muscle tension headaches, chronic cervicalgia, & TOS are common in those with Fibromyalgia.
Sine qua non of Fibromyalgia (FM) is both chronic upper & lower back pain. Chronic muscle tension headaches & chronic cervicalgia (due to Superior trapezius muscle spasm) & TOS are common elements of the upper back pain component of FM.
The element of lower back pain in Fibromyalgia is sacroiliac joint (SIJ) subluxation chronic pain disorder syndrome (named by author), which is often due to chronic ligament laxity of one SIJ, but that is another story (see my threadreaders about Fibromyalgia).
Back to chronic pain syndrome subsets of Fibromyalgia & which each evolve differently & with specific chronic spastic painful hypertrophic/hyperdynamic muscles as result of chronic biomechanical gravity stress:
TEMPORAL MANDIBULAR JOINT (TMJ): My clinical research has identified unilateral Masseter muscle hyperdynamic function as etiologic for chronic wear, injury, & dysfunction of a TMJ. The medically correct name of this disorder is Temporal Mandibular Disorder, TMD.
TMD commonly evolves on side of the face most uppermost within a head that is chronically tilted; wherein weight of the higher mandible evokes dynamic Masseter function & asymmetric jaw function; as brain motor centers attempt to maintain symmetric right to left dental occlusion.
The tilted head/neck can be discovered to result from asymmetric hemi-girdles of the shoulders (each shoulder has an hemi-girdle) overlying an underlying functional scoliosis (common in those with Hypermobility Syndrome).
CHRONIC CERVICALGIA: Commonly one Superior trapezius (ST) is hypertrophic (greater girth anterior leading edge) & hyperdynamic; due to chronically tilted 10 pound head; supported mostly by stronger ST of cervical/shoulder Superior trapezium pair; supporting becomes hypertrophic.
CHRONIC CERVICALGIA is manifestation of entheses at insertion sites of Superior trapezius (ST) upon Occiput & upon Superior Scapula Spine plus painful muscle spasm impinging ST muscle mid-body motor point, a neural network in the mid-part of Superior trapezius upper aspect.
MIGRAINE HEADACHES: A pain syndrome that commonly expresses in those persons who have daily muscle tension headaches; due to chronic cervicalgia as explained above.
MIGRAINE HYPOTHESIS: Migraine represents brain tissue arteriolar wall smooth muscle spasm; resultant from autonomic neural feedback initiated within a chronically spastic Superior trapezius muscle.
THORACIC OUTLET SYNDROME: An hypertrophic & hyperdynamic Superior trapezius (“shoulder elevation” muscle) evokes hypertrophic development of opposing shoulder muscle of shoulder “draw-down”, the Pectoralis minor muscle; a true crossed muscle syndrome.
When arm abducts, Superior trapezius folds/relaxes & an hyper-dynamic (from chronic opposition to an hyper-dynamic Superior trapezius) Pectoralis minor muscle draws distal clavicle forcefully/excessively in inferior direction; as a bone radius fixed at sternoclavicular joint.
One cm of excessive inferior shift of the distal clavicle (18 cm & fixed at the sternoclavicular joint) closes the costo-clavicle dimension (Thoracic Outlet) by 30%; therein impinging the contained brachial neurovascular bundle, i.e., evoking the Thoracic Outlet Syndrome.
As a unilateral muscle of a symmetric pair (or one muscle of an opposing pair of muscles) is hyperdynamic/etiologic for a chronic pain disorder, we might hypothesize that Botox would be a natural application for crossed muscle conditions; a true Principle of Diagnosis & Therapy.
In medicine when a therapy dedicated to a theorized diagnosis then successfully evokes relief of the symptoms of the diagnosis or otherwise cures the suspected diagnosis, it can be said that the “treatment proves the diagnosis”.
Botox is a natural organic substance that in large doses is a poison to the human body, but in small doses is a miraculous treatment. Botulinum toxin is a true Principle of Treatment & Diagnosis.
In the future, physicians will be able to gather clinical data to prove the diagnostic and treatment hypotheses espoused within this essay. They will then demonstrate certain singular Principles of human functioning and Pathophysiology.

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More from @BadgleyLaurence

Apr 16
LOOSE JOINTS, HYPERMOBITY? Gravity is at play in these women with tissue variations. When joint are unstable the obvious compensation is “gorilla” muscles to take over lax ligament efforts. A wise Physical Therapist is key. Lots of dedicated exercise also.
LOOSE JOINTS INHERITED (-15% women) is normal. These woman’s have easier births & indigo-smart children. These women are often quite attractive and smart.
ABORIGINAL SOCIETIES
CHERISHED HYPERMOBILE
WOMEN BECAUSE THEY WERE SMART & PROLIFIC BIRTHERS. INTELLIGENCE GENES LIKELY GROUP WITH HYPERMOBILITY GENES & GENES FOR BEAUTY. MEN WANTED FECUND ATTRACTIVE WOMEN SO THEY SELECTED THEM OUT.
Read 6 tweets
Apr 14
HYPOPERFUSION? Yes, maybe sympathetic nervous system dominance + decreased pituitary vasopressin causing excess free water elimination in urine ⏩️ decreased blood circulation of hyperosmolar blood.
COVID-CAUSED decreased blood volume of blood that is too thick might explain orthodtstic hypotension, POTS. Might also explain the wormy blood clots.
COVID-CAUSED diminished total blood volume might evoke sympathetic nervous system activation to prevent hypotension and prevent syncope. Diminished blood volume would be expected to deliver less oxygen to tissues ⏩️ fatigue & exercise intolerance.
Read 5 tweets
Apr 9
TO BE GAY ON NOT, THE QUESTION? In ancient days of the mid last century, the proper medical terminology was “homosexual”. Homo is a Greek prefix for “man” such as used in our species name, homosapiens, I think. Along the way a new adjective/noun, a euphemism, was created, “gay”.
“GAYNESS” might be adverb. I don’t know, grammar not my long suit. In any case, Anthropologist of last century seemed to be of consensus that a fixed ~15% of the population was homosexual as a transcultural genetic characteristic of homosapiens. Indeed, genes direct hormones.
TO BE GAY OR NOT: THE “GREAT H & E DEBATE” (heredity vs. environment) is a dynamic that has ever lent unending entertainment and fascination to the study of the human condition & especially to the world of medical studies.
Read 7 tweets
Apr 6
MCAS IN LONG COVID: is possibly etiologic via biomechanisms known about MCAS, HYPERMOBILITY (HS) & FIBROMYALGIA (FM). Persons with HS & FM commonly suffer MCAS. Reason has been theorized that mast cells reside proximate connective tissue.
MCAS, HS, & FM: hyperflexible connective tissue evokes mast cell degranulation. Reactive substances provoke proximate neural tissues. Some experimental data for this dynamic. It might be that those with long COVID & MCAS expression might have hypermobility (about 15% women).
Read 11 tweets
Mar 12
IC CAUSE DISCOVERED: for years clinicians have been mystified by etiology of IC. Genes, microbes, toxins, & biochemistry have failed to provide insights. IC oft occurs in women who have Hypermobility Syndrome and/or IBS. These circumstances suggest that IC is a dysautonomia.
IC A DYSAUTONOMIA? parasympathetic part of autonomic system stimulates smooth tissues of bladder & bowel to contract/evacuate those organs. Over activity of this neural network is unmeasurable, as yet, in current medical sciences. Absence of evidence is not evidence of absence.
IC CLINICAL DATA: hypermobile women are potentiated for developing pelvic girdle instability from loose sacroiliac joint (SIJ) ligaments & are prone to Mast Cell Activation Syndrome (MCAS). Dr. Afrin’s book explains MCAS. I published case studies of IC remission via SIJ fusion.
Read 9 tweets
Mar 12
IRRITABLE BOWEL SYNDROME: doctors will tell you the cause is “unknown”. This is not true. IBS is commonly found in women either Hypermobility Syndrome. Reason is that these women are prone to pelvic girdle injuries and ligament laxity of one of the sacroiliac joints.
IBS & HYPERMOBILITY SYNDROME: This association well known in medical circles. Some of these women have regular daily frequent loose stools. Some have intermittent episodes of several days of constipation. Another set of these women have alternating constipation and loose stools.
IBS EXPLAINED: reason cause is “unknown” is that anatomical, tissue, and biochemical explanations are unknown and wanting. However, the dysfunction of the bowel suggests the cause is dysfunction of the autonomic nervous system, the parasympathetic and sympathetic.
Read 14 tweets

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