True Story: I Got Botox in My Shoulders to Help Fix My Posture

Fact checked by Lisa SullivanReviewed by Rachel Nazarian, MD, FAADFact checked by Lisa SullivanReviewed by Rachel Nazarian, MD, FAAD

About an hour before my first-ever Botox consultation at GoodSkin, the L.A. anti-aging clinic known for its "untouched" approach to injectables, I mournfully looked at our editorial calendar before deleting a future story titled "Natural TMJ Remedies That Worked for Me." This rough headline had been pushed again and again for months as I exhaustedly tried to address the chronic tension in my jaw—ultimately to no avail. I was bummed, to be sure, that after months of self-massage, aromatherapy, and tackling the source of my stress in meaningful ways, I hadn't found the noninvasive solution I was looking for. At the same time, while the prospect of getting Botox in my jaw was my Hail Mary, I had a sneaking suspicion that it would be the technique that would finally give me the relief I craved. What I didn't know was that it was going to be life-changing for my shoulders and posture, as well.

As I sat opposite Lauren Pack at GoodSkin and she expertly ran her fingers along my jaw and chin, noting the anatomy of my face, she lobbed a question that seemed only slightly out of left field. "Do you have any issues with your posture?" she asked. I laughed in response because my perpetually slumped shoulders might be even more irksome than my stiff jaw. Her suggestion to my achy joint woes? Botox. "I can give you jaw Botox," Pack said. "But I'd like to put some in your neck as well." Keep reading to learn how Botox for shoulder and neck pain helped me.

Meet the Expert

• Lisa Goodman is the founder of GoodSkin.

• Lauren Pack is a registered nurse at GoodSkin.

• Dr. Howard Sobel is the is a board-certified dermatologist based in New York City. He operates his eponymous skincare line, Sobel Skin Rx and is a Clinical Dermatologic Surgeon at Lenox Hill Hospital.

• Dr. Kenneth Mark is a board-certified dermatologist specializing in cosmetic dermatology.

What Is Botox?

Before getting into the benefits of Botox on shoulders, it's important to first understand what Botox is. According to the Cleveland Clinic, the injectable is a neurotoxic protein that, when used in small amounts (typically on the face), can cause controlled muscle relaxation. As a result, Botox has been used for years and is (thankfully) FDA-approved.

Botox has most commonly been used to treat fine lines and wrinkles in the forehead and under the eyes but, as the experts at GoodSkin note, it can do a lot more—targeting the muscles in other parts of the body, so that they can relax. "The neck muscles become overactive when we lean forward (think sitting on our computers/tech neck)," says Lisa Goodman, founder of GoodSkin. "These stiff muscles then pull the head into a forward position, which can then cause the shoulders and traps to compensate into a hunched appearance. The traps become larger (think football player) and the spine more curved—and there you have it in total: bad posture. Botox relaxes the muscles so you can more easily have correct posture."

Benefits of Shoulder and Neck Botox

According to board-certified dermatologist Dr. Howard Sobel, "Botox in the neck area helps relieve pain from muscle tightness due to stress, improves upright posture, slenderizes the neck, and elongates the shoulders." Improving upright posture helps to eliminate "tech neck," which is stiffness and poor posture that comes from being hunched over our devices (yikes).

Pack explained that by dosing my neck with Botox, she'd prevent those muscles from overcompensating for my jaw. What's more, she said that it would encourage me to shift that work to my core muscles and pull my shoulders back, correcting my posture and even potentially giving my abs a nice workout in the process. "So, in a way, you could almost say that Botox can give you a toned stomach," she half-joked.

The increased abdominal workout is an added bonus, but the real draw for those of us suffering from bad posture is that Botox forces our muscles to correct themselves. As Goodman notes above, Botox can relax the hunched shoulder muscles, removing tension from the head and neck and altering the way we stand and sit.

What to Expect From Shoulder and Neck

In terms of the actual injections, you'll feel a slight pinch with each needle injection. Beyond that, however, it's important to think about the big picture of getting Botox on your shoulders.

Pack clarified that this wasn't a magic potion that would relieve everything that ailed me (including, apparently, un-toned abs). I'd also have to engage in what she called retraining exercises, simple tips, and movements that would help me work the right muscles as the injected ones began to relax. When I was driving, for example, she recommended that I focus on pressing my tongue to the roof of my mouth to relax my jaw and to roll my shoulders back so that my neck would follow—basically, the antithesis of being hunched over my phone. In other words, the Botox would give me a head start, but I'd still have to put a little effort in to fix years of jaw-clenching and terrible posture. Fair enough.

Side Effects

Initial Soreness

A week later, I was breathlessly waiting for any kind of indication that the Botox had kicked in. Then I began to feel it in twinges and aches. My neck began to feel exponentially sorer as I scrolled through Instagram. Slouching, in general, began to feel uncomfortable, and I was shocked to feel relief as I sat up straight and rolled my shoulders back. This, Pack reiterated over email, was all very normal.

"When the muscle is weakened, and you are in that position you will become sore quicker, which is a good thing," she wrote. "It will remind you to not be in that position. [And ultimately], it can definitely provide relief for muscles that are radiating into the back or head and causing muscle aches or headaches."

Fewer Headaches

Something else I learned was that getting Botox injections in your neck and shoulders can also benefit people with chronic migraines—and that soreness following the injections is to be expected. "Trapezius Botox can be very beneficial to those who carry stress and tension in their neck area by hunching their shoulders and contracting their trapezius (a muscle located at the back of the neck)," says board-certified dermatologist Dr. Kenneth Mark. "It can also help headaches as some people suffer a vicious cycle when a headache occurs as it contracts their traps. As a result, the headache gets worse and tension in traps gets worse."

According to the American Migraine Foundation, "While Botox-A is a remarkably 'clean' treatment for the prevention and suppression of headache, side effects can occur. The most common of these is neck pain and stiffness, often accompanied by what has become known as 'wobbly neck' or 'bobblehead.' Injection of Botox-A into the muscles of the neck and upper shoulders may cause temporary partial weakness in those muscles…but will resolve within days to weeks."

What Are the Downsides of Trapezius Botox?

According to Sobel, if the Botox is not properly injected in the trapezius and surrounding area, there can be weakness in the neck muscles. Like with any type of Botox injections, finding an experienced injector is so important.

Furthermore, if you turn to Botox as treatment for headaches but the source of your headaches is something like cervical disc damage, neck Botox can do more harm than good. "It could be very counterintuitive and counterproductive to weaken your traps if you're having headaches and neck pains originating in the cervical spine," says Mark. Definitely spend some time consulting with your doctor about the source of your headaches before immediately turning to Botox as a fix.

Aftercare

Just as with facial Botox, after getting injections in your neck and shoulders, it's best to avoid strenuous exercise for at least an hour. Additionally, to avoid bruising, it's recommended that you don't drink for 24 hours post-treatment. Believe it or not, many dermatologists even recommend laying off the beer, vino, and spirits a day beforehand for the same reason. Other than that, you're just not supposed to touch or massage the injection sites for the next six hours to avoid accidentally reshaping the Botox and potentially causing an adverse appearance.

Appeased to know that things were working beneath the surface, I turned my attention to aesthetics: specifically, that my jawline had grown subtly sharper over the course of a few days. The red dress image above was taken about a week after my appointment, and while it's apparent that my shoulders are still overdeveloped from slouching (and my posture still needs work), it was while posting this photo that I noticed more definition in the lower half of my face. Then, I instinctively tried to relax my jaw before noticing that it wasn't clenched in the first place—a sensation that felt completely foreign to me.

I'd have to wait a few more weeks to see changes in my shoulders, posture, and core, during which Pack advised me to continue my fitness regimen as usual to see the biggest impact. "If your neck isn't recruiting while working out, then your core will have a better chance of activating," she explained. "A stronger core also equals better posture."

The Final Takeaway

While I can't exactly claim that Botox gave me a six-pack, I ultimately realized just how true it is that the quickest, cheapest way to look longer and leaner is to stand up straight. As my shoulder muscles began to lose their bulk and my neck learned to stop pitching forward, suddenly it was easier to see definition in my midsection—not because I was hitting the gym any harder but because I was carrying myself differently.

The visual gratification has been undeniably nice, especially after years of critiquing my hunched appearance in photos. (I was sure I was standing up straight!) But to me, addressing my physical manifestations of stress was the end goal I hadn't necessarily anticipated reaching. I certainly couldn't have imagined it in the hours before that initial consultation, when I wondered if my clenched jaw was a hopeless case.

I have read studies that illustrate just how much we "store" and internalize tension (and even emotion) in our physical bodies, which in turn feeds back into our mental state, an endless loop of psychosomatic pressure. It's a topic that fascinates me, but to truly experience the flip side of this—what happens when we invert this tension into relaxation—has been a salient reminder that often, addressing chronic stress from a purely physical place is a promising first step to feeling better all around.

Is it a shortcut to use Botox as a means to this end rather than, say, yoga? Perhaps—and not a cheap one, at that. But I also stand by the notion that when offered a tool to find potential relief, there's no use in continuing to suffer on principle.

And good posture? Well, that's just a sweet bonus.

Frequently Asked Questions

How many units of Botox are injected into the shoulders?

According to Sobel, expect "30-50 units on each side of the neck or shoulders."

What does Botox in your shoulders do?

"Traditionally, I injected the neck with Botox to weaken the "depressor" muscles including the platysma bands for a neck and jowl lift," says Mark. "However, more recently, people are injecting the trapezius area to help with pain and tension."

What is the aftercare for shoulder Botox?

According to Sobel, slight bruising is common. The results typically last for three to six months.

Read the original article on Byrdie.