Finding a treatment that works for your migraines (i.e. chronic migraine, tension-type headaches, etc) can be a long and stressful experience. Botox treatment has been found to be an effective way of managing and controlling migraines. Although people generally associate Botox with reducing the appearance of facial wrinkles, Onabotlinum toxin A. or Botox, was approved in 2010 to treat chronic migraine headaches. Botox injections are generally a last resort once patients have failed other oral medications such as beta blockers, anti epileptics, antidepressants, and CGRP blockers.
It should be noted that Botox has been found to be effective in treating chronic migraines and headaches (including tension-type) that occur on 15 or more days in a month, lasting 3-4 hours or longer. Cluster headaches and less-frequent headaches such as episodic migraines are generally not appropriate for Botox treatment. Make sure you are properly diagnosed by your primary care provider or neurologist before proceeding.
How It Works
The pathophysiology of migraines is theorized to involve sudden waves of activity from groups of excitable brain cells causing the firing of electrical signals in the brain which can in turn cause narrowing of blood vessels. Botox treatment is believed to be taken up by pain receptors within the muscles’ nerves and deactivating these receptors which ends up blocking the pain signals that the nerves send to the brain. Repeat Botox injections are done after several months as nerves sprout new pain fibers leading to the return of headaches (generally 2.5-3 months). Injections are limited to once every 3 months due to the possibility of the body building up antibodies against botulinum toxin.
Side effects can include:
- Swelling and bruising at the injection site (usually resolved after 2 weeks).
- Medication spreading can cause various side effects (i.e. Drooping eyelids, difficulty raising eyebrows, dry eyes, or excessive eye tearing due to medication spreading.
- Muscle weakness and neck pain.
- Vision problems, difficulty speaking or swallowing, and difficulty breathing.
- Recommended against use with individuals who are pregnant due to unknown side effects on a fetus.