Resources > Phenol vs. Botox vs. Cryoneurolysis: What’s the Difference?
Phenol vs. Botox vs. Cryoneurolysis: What’s the Difference?
Spasticity can lead to pain, reduced mobility, and difficulty with daily tasks. One of the ways spasticity is treated is through a technique called chemodenervation, which uses targeted injections to reduce the abnormal nerve signals overstimulating the muscles.
Think of the muscles like speakers blasting sound, and the nerves like the wires carrying those signals. Chemodenervation works by adjusting that signal by either turning down the speaker (botulinum toxin), cutting the wires (phenol) or pinching the wires (cryoneurolysis).
The following are three treatment options for managing spasticity through chemodenervation, each with unique advantages depending on the patient’s needs and clinical goals.
Botulinum Toxin (Botox, Dysport, Xeomin, Myobloc): Turning Down the Volume
Botulinum toxin injections for spasticity relief are injected directly into the muscle. It works by blocking the nerve signal where the nerve meets the muscle. Think of it like turning down the volume on a speaker. The signal is still there but it’s no longer blasting at full strength.
- Target: Muscle
- Duration: Usually lasts 3 months
- Reversibility: Fully reversible
- Insurance: Generally covered
- Notes: All brands work similarly; the choice usually depends on insurance or provider preference.
Phenol Nerve Blocks: Cutting the Signal
Phenol is injected near a nerve, where it chemically destroys the fibers that carry the signal to the muscle, like cutting the speaker wire altogether. It’s often used when the patient needs stronger, longer-lasting effects, or when the muscle is no longer contributing to useful movement.
- Target: Nerve
- Duration: Can last a few weeks to even a year or two years. On average 6 months is expected.
- Reversibility: Partially — nerves may regrow, but not always fully
- Insurance: Partially covered
- Notes: Over time or with repeat injections, phenol can lead to muscle weakness due to nerve damage and incomplete regeneration.
Cryoneurolysis: Temporarily Freezing the Nerve
Cryoneurolysis freezes the nerve just enough to stop it from sending signals, like pinching the wire instead of cutting it. This damage is temporary, and the nerve is likely to regrow in a predictable way. Although cryoneurolysis is a promising and emerging technique, it is not yet FDA-approved for the treatment of spasticity and is typically not covered by insurance. As a result, our clinic does not currently offer cryoneurolysis, but we continue to monitor its progress and evolving evidence.
- Target: Nerve
- Duration: Typically lasts several weeks to a few months
- Reversibility: The nerve often regenerates
- Insurance: Not usually covered
- Notes: Still considered investigational for spasticity
Which Option Is Right for You?
Each of these treatments has its strengths, and the right one depends on your goals, the severity of your symptoms, and which muscles or nerves are involved. At our clinic, we tailor each treatment plan based on your specific needs. Choosing the right tool at the right time to help you move more comfortably and function more independently.
Have questions about which option might be best for you or your loved one?
We’re happy to walk you through it during a consultation.