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Where sterile water becomes the wrong choice is in any multi-dose scenario without a preservative, each additional needle insertion introduces contamination risk that compounds over time

This could be Monday morning, for example

Psychological stress raises cortisol and adrenaline, which increase muscle tone and reduce the threshold for spontaneous contraction

Simpson DM, Hallett M, Ashman EJ et al (2016) Practice guideline update summary: botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: report of the guideline development subcommittee of the American academy of neurology