Get Better. Faster.
Dr. Silberman specializes in the diagnosis and treatment of exertional
compartment syndrome.  Compartment testing is the gold standard for
the diagnosis of exertional compartment syndrome.  He has been
performing compartment tests since 2003 and is a referral source for
orthopedic surgeons located throughout the United States. He has
presented cases at national conferences and has been published in
peer-reviewed scientific journals on the topic of exertional leg pain and
compartment syndrome.  He has had an interest in exertional
compartment syndrome since fellowship when he presented research on
the low success of surgical treatment at the Annual AMSSM Sports
Medicine Conference.  He has performed over 500 compartment tests
and currently averages more than one per week.

Botox injections are a novel non-surgical intervention that appears to
have promising results in published case studies.  Dr. Silberman has been
performing botox injections in his practice since 2012.  After seeing
surgical failures for exertional compartment syndrome and having to
retest patients who underwent surgery, where extensive scar tissue could
be felt during retesting, Dr. Silberman began investigating botox as
another option.  
New Jersey Sports Medicine is the only known center
in the United States to offer Ankle Brachial Index Testing,
Compartment Testing, and Botox injections for exertional leg pain
under one roof.  
Dr. Silberman knows exactly where the pressures are
the highest based on the compartment test and thus knows where best to
inject the botox.  Dr. Silberman has successfully treated patients with
botox who failed fasciotomies; and to date, no athlete who has undergone
botox treatment by Dr. Silberman has had to have surgery.  Dr.
Silberman has also helped athletes with exertional lower leg pain return to
running by working on their running form.

The Process:
After consultation, which may include an Ankle Brachial Index (ABI)
Stress Test (...
Dr. Silberman has diagnosed Popliteal Artery
Entrapment Syndrome in someone who failed fasciotomies for
'compartment syndrome'...
), a Compartment Test, review of imaging,
and video gait analysis, the amount of Botox that will be used for your
treatment is calculated and a prescription for Botulinum Toxin Type A
(Botox) will be given to you to be filled at a pharmacy.  You will then
return on another day with your Botox medication which must be stored
in a refrigerator 2° to 8°C (36º to 46ºF) and brought in to the office on
ice, recommended within one hour.

Dr. Silberman performs Botox injections for compartment syndrome
under ultrasound guidance. The injections do not cause the same amount
of discomfort that the compartment test may have caused.  A local
anesthetic will be used and the needle that is used for the Botox injection
is a smaller gauge than the compartment testing needle.  Botox injections
for compartment syndrome are not covered by insurance.  The cost of  
botox injections for exertional compartment syndrome affecting the
anterior and deep posterior compartments in bilateral legs is $2000.

What to expect:  You may experience some soreness from the needle
and/or the Botox itself after the procedure that may last one to two
weeks.  You may experience temporary weakness in the muscle as well.  
Within one week, you may already experience a decrease in pain and
symptoms.  Within 2 weeks, you may resume light running.  Within one
month, you may be back to sports fully.

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Get Better. Faster.
Botox for Exertional Compartment Syndrome
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