5 things you need to know about Botox for migraines

5 things you need to know about Botox for migraines

In 2010, the U.S. Food and Drug Administration (FDA) approved the use of Botox, or onabotulinumtoxinA, for the treatment of chronic migraine, a serious medical condition that affects an estimated 3.2 million Americans. 

Since then, thousands have sought relief for their aching heads from the muscle paralysis-inducer typically used for reducing skin wrinkles. But how do you know if Botox is right for you? Dr. Raina Gupta, neurologist at Advocate Illinois Masonic Medical Center in Chicago, shares five things you should know about Botox treatment of migraine. 

1. How bad do my headaches have to be?
Botox has been proven effective only for the worst clinical definition of migraine, chronic migraine. Chronic migraine sufferers experience a moderate to severe headache for more than 15 days out of the month, with the pain lasting for four hours or more at a time. Women are most affected by chronic migraine, which typically causes pain on one side of the head or forehead, sensitivity to light and sound and even nausea or vomiting. Other prescription treatments should be attempted first. Botox has not been proven effective for other types of headache, such as less frequent migraine and tension headaches. 

2. Botox is a toxin?
Botox is a toxin, but it is not poisonous. The FDA has provided full approval for the product to be used to treat chronic migraine. Botox is derived from the bacterial toxin that causes botulism, but has been determined safe in the doses provided by physicians. Many other medications are also considered toxins and are also dangerous, when taken at the wrong dosage.

 3. How does the Botox treatment work?
Scientists are still researching the exact nature of the effect of Botox on chronic migraine. It is suspected that, when injected into the head, neck and shoulder muscles, the toxin blocks certain chemicals from reaching the nerve endings that cause the migraine pain. The effectiveness of the drug is noticed about a week following the injection cycle, peaking around six weeks following and fading within about three months. Though some patients notice a difference following their first treatment, relief may not be felt until treatment is repeated two or three times. 

4. What does the treatment involve?
The full treatment with Botox for chronic migraine requires a series of small injections to seven key areas of the head, neck and shoulders. A total of 31 injections are required and cause little discomfort. The series of injections, if effective, are repeated every three months. 

5. What are the possible side effects?
When performed by your physician, Botox injections generally are safe. However, some side effects may occur. About 9 percent of patients in the clinical trials reported experiencing temporary neck pain, and about 5 percent experienced headaches. Other possible adverse reactions can include pain at the site of injection, temporary swelling or redness, and, in extreme cases, muscle weakness, drooping of the eyelid and difficulty swallowing or breathing. Women who are pregnant or breastfeeding should not use Botox. 

“Botox is a safe, effective treatment for chronic migraine that can reduce the dependency on other prescription medication for some people,” says Dr. Gupta. “I definitely recommend this to my appropriate patients, as it’s a great alternative or accompanying treatment.”

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  1. I have migraines but can’t imagine getting 15+ days each month? Yikes that’s really awful.

    • Yep, it really does. 8 months with only 5 days without a severe headache or migraine. I can honestly say, its a miserable way to live. I cant wait to get these injections done and am desperately hoping they work

  2. My migraines started when I was 40 – one every now & again. By the time I was 50, I was in pain almost constantly, and taking medication too often could cause “rebound headaches” which only made it worse. Botox has been an amazing solution for me. I still get migraines, but much less often and much less intense. I don’t mind getting 31 injections in my scalp every 3 months (and yes, they do hurt, a little). The benefits have changed my life.

  3. I have migraine but its not chronic . It occurs three or four times a month. When I heard about Botox treatment for migraine, I planned on taking it. But after reading this article I think it could not be effective, I am changing my plans. I heard about side effects like losing bladder control, muscle weakness, vision problems could arise if the treatment is not done properly by someone who is not properly trained in Botox treatment. But worse effect will be when the treatment being ineffective after spending a good amount on it.

  4. I had no idea that botox could treat migraines. That’s great news! My wife has always struggled with migraines. I think it would be a good idea for her to look into botox. It might be the only thing to help her. Nothing else seems to work. http://www.kleydmandermatology.com/services/botox-cosmetic

  5. For the past two years, I have been dealing with a lot of migraines and so a friend of mine recently suggested that I should try Botox to help with them. Although getting 31 injections sounds a little bit intimidating to me, it might be worth it. However, is this a one-time thing or how often would I have to get these injections?

    • You get the Botox injections every three months, they are done with a very tiny needle and are nearly pain free. I highly recommend Botox injections for anyone that has chronic severe migraines! They have worked wonders for me.

  6. I used to have migraines symptoms every day. I learned to live with the migraine. Sometimes I had to stay in bed when the symptoms were too many, blurred vision, depression, upset stomach, nausea, headache on both sides, neck and shoulder pain,fatigue ,sleepy, a woosh sound in my ears. After being very sick for three days, my body took couple of days to recover.However ,the light headache was always present. I went to see a new neurologist who recommended Botox injections. I’m on my third round of Botox . Yes, I get 31 injections every three months. From having migraine symptoms every day ,now I have 2 – 5 a month. When I have them they are less intense and they may last 4 hrs. Botox injections have work for me. I feel that I have my life back.

  7. Lillian Schaeffer April 11, 2017 at 11:15 am · Reply

    Thanks for bringing to my attention that Botox can help with those with chronic migraines. I’m susceptible to migraines, and I’ve been getting them more and more frequently. I want to have it treated, but I don’t want an invasive procedure done. Maybe Botox would be a good option for me because it isn’t a complicated procedure.

  8. Troy Schumacher May 18, 2017 at 12:36 pm · Reply

    I never suffered from chronic migraines or even had headaches until a bad accident at age 35. Since the accident i suffered from a severe concussion and started getting migraines. I tried a bunch of medication prescribed by my neurologist and nothing was working so we decided to do botox. It has been a lifesaver. I still get an occasional migraine but i went from 15 plus migraines a month, numerous trips to the ER, to maybe 2 to 3 a month if that. Im now on my 3rd round of botox’s. The only draw back that i have experienced or side affect is some neck pain. Ill take the neck pain/discomfort any day over the 15 plus migraines i was having. I would prefer to not have to take botox long term and find a better alternative so we will see after this round how i do if i choose to stop the botox and see if the migraines come back.

  9. I’ve experienced chronic migraines since childhood. As I’ve gotten older the migraines have gotten worse and lasted longer. This last migraine lasted over 18 MONTHS! Yes, I’m serious. I’ve seen many doctors and “specialists” related to reducing, removing, or otherwise calming my migraines. Hypnosis, Yoga, meditation, Injections of one sort of another of migraine treating medications, ER visits, pain medications from the typical (Fioricet to Toradol, to the atypical, such as Topamax, Inderal, and more)

    My neurologist suggested Botox and I was game for just about anything except sacrificing a chicken.

    I saw my neurologist for an emergency appointment for “something” to help with the pain until my Botox appointment in about 10-14?days. Was I surprised when the neurologist said, “why wait? Let’s do it now.”

    I was given Toradol and Phenegran injections in each hip and then Ivteceived the (I lost count) Botox injections in neck, upper shoulder blades, across forehead at hairline, on sides of temples and I really couldn’t tell you where else.

    Did it hurt? YES!

    Little needle, sure. But it’s injecting into areas with no muscle!!

    I’ve experienced a break in the migraines, but they haven’t gone away forever. This is now day 5 of the injections and I did end up in the ER on days 3-4 with excessive exhaustion, diarrhea, vomiting, high blood pressure, high pulse, inability to keep eyes open.

    Today, I’m still resting, still recovering and still have a headache. Mind you, that’s HEADACHE, not MIGRAINES.

    I understand that it’s going to take a few treatments to determine if Botox for Migraines actually works for me.

    In the meantime, life is pretty much status quo. I’m exhausted, weak, unable to do much, battling flares of Ulcerative Colitis, SIADH, and a list of other disorders longer than you’d think, but, at least I’m not licked in my darkened bedroom, eye mask on, ice packs surrounding my head, and floating in and out of consciousness depending on the pain drug de jour.

  10. I have chronic migraines and have used Botox. 31 injections and they really hurt regardless what other people say. The injections worked for a little bit on second session but not at all for first and third sessions. Looking for new drugs in pipeline. And yes I use Keppra for preventative.

  11. I have headaches day in day out 24/7 and im not allowed to work and been signed off iv had these injections and unfortuntly it made me a lot worse and I had bad reactions I was that 2% of bad rections in people I have tried ending my life as I cant coupe but im now on (big gun tablets) what could make a lot of people ill and not coupe but they have worked a bit but not a lot and that’s the strongest tablet they do as it what they use for people who are in terrible pain or even dying but I want to wish everyone good luck with this injection

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health enews Staff
health enews Staff

health enews staff is a group of experienced writers from our Advocate Health Care and Aurora Health Care sites, which also includes freelance or intern writers.