Gosh, I really feel for your husband! Chronic pain is debilitating! And muscle cramping feels terrible. Is he constantly in that state of what a Charlie horse feels like? Botox is such an interesting medication. It is used for kids like my son who have severe gastrointestinal problems and a slow gi tract. How, what or why that works is beyond me. I think the downside of using botox is that it 'could' potentially go to other areas and affect swallowing, breathing or moving. It also didn't get a back indication (for pain) because the studies didn't prove it helped any better than other therapies commonly used. I also think the injections can be quite painful. However, your husband has tried many things. Weighing the potential benefit verses the risk, he sounds to be near meeting criteria to try the botox. Has he had another opinion recently? What type of doctor is he seeing right now for this?