Botox injections (Botulisum Toxin Type A) can force tight muscles to relax. These painful muscle knots are often found in the shoulders, neck, low back, buttocks, and thighs. When standard trigger point injections fail to relax the muscle, Botox injections can often be used. Typically the medication does not actually work for one to two weeks following the injection but many patients experience relief within days of the injection. The effect of the Botox typically wears off within three to four months. If used frequently, a patient can develop antibodies to the medication and it will begin to lose its effectiveness. The patient will follow the series of injections with a consultation with the doctor to assess the effectiveness of the injections.