FOUR years after falling over some carpet and damaging her back, bank worker Samantha Isaacs was beginning to wonder if her life would ever be normal again.

"It never went away. Even on my honeymoon I spent three days in a wheelchair because I couldn't walk," recalled the mother-of-three from Bournemouth.

"I've seen three specialists, three physiotherapists, a chiropractor and an osteopath and had three MRI scans.

"I walked like an old lady and I made my back worse by sitting down for a long time," she said.

"It was soul-destroying. I was permanently on tablets to help me sleep - I was getting three hours a night, which made me groggy. I was taking anti-inflammatories and pain killers that made me really sick and dizzy."

Samantha, 36, of Northbourne, eventually went to a private spinal clinic, where pain specialist Dr Maher Michel injected her with a dilute and purified form of the botulinum toxin - the bacterium that causes botulism food poisoning.

As Botox, the preparation has been used in the UK for more than 10 years and was originally introduced to treat severe muscle imbalances in conditions such as crossed eyes, stroke, brain injury and cerebral palsy.

Now better known for its cosmetic uses, it works by temporarily blocking the signal from the nerve to the muscle, allowing the muscle to relax. When injected into the facial muscles, it has the effect of smoothing out deep frown lines.

Dr Michel has been using injections for patients with back pain for the last year, but stresses they are not suitable for everyone.

"I don't use it as the first line of treatment. Not every patient with chronic back pain will respond," he said.

"The main component has to be muscular, rather than joint or nerve.

"Usually patients will have a combination, but with some, like Samantha, when you look at their X-ray or MRI scan, you won't find too much evidence of bone or nerve problems."

At the Spinal Pain Clinic in Queensmount, the botulinum toxin injections are used in conjunction with physiotherapy.

"From our experience, the treatment works well if the patient has regular sessions of physiotherapy. The idea is that it helps patients to use their muscles properly afterwards," explained Dr Michel.

"When you relax the muscle, it gives you a better environment for healing and hopefully, when it recovers after three to six months, it won't be as bad."

Small muscles may be injected in one or two places and larger muscles may need three or four injections. The effects are usually seen within three to 10 days and last an average of four months.

"Botox is not a cure, and although it does wear off, it sometimes spells relief when nothing else does," said Dr Michel.

"It's not a miracle drug, but it's certainly something one can try when other drugs fail."

Samantha had her treatment in early August and attends sessions once a week with Kate Rowe-Jones, who uses a combination of acupuncture and physiotherapy.

As for Samantha herself, she is delighted with the improvement in her condition. "I'm not fixed, but there's light at the end of the tunnel," she said.

"Before I had the injection, I was so depressed. I was sitting down all day, which was impacting on the pain.

"At one point, the children were getting their own tea and doing the vacuuming for me because I couldn't.

"Now I'm doing lots of swimming and exercises on gym balls, strengthening muscles that don't know how to work any more. I went on an activity holiday with my children. They're so proud of the fact that I was one of the few mothers doing rock climbing and abseiling.

"I can walk the dogs and play football with the kids. I go dancing and I go to the gym three times a week.

"I'm off sleeping tablets and don't take pain killers much.

"If I have a lapse - half an hour with Kate, and I'm back on track."

At the moment, Botox is not licensed for use on back pain and is only available for such treatment at a handful of NHS centres, none locally.

For more information, telephone Kate Rowe-Jones at Rowe-Jones Associates Ltd on 01202 391144.