The key to the successful treatment of patients with spasticity is contingent on choosing appropriate interventions tailored to meet the needs, goals, and specific presentation of each patient. For the clinician attempting to address the focal manifestations of hypertonia without surgical intervention, there have been 2 primary options: neurolysis or chemodenervation. Before the introduction of the botulinum toxins, neurolysis was the only focal spasticity treatment option available to the previous generation of physical medicine and rehabilitation practitioners.