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Can You Drive After Botox Injections For Migraines

What Happens When The Treatment Wears Off

48 hours after botox for migraine injections

The benefits of Botox usually start to wear off after 1012 weeks, when you may begin experiencing more frequent headaches or migraines. Injections are given every 12 weeks, so there may be two weeks where you may need other medication to ease your symptoms. Speak to your GP about what medication you can take.

How Is Botox Used To Treat Migraines

Botox is a recommended treatment for people who suffer from regular, chronic migraines or headaches. Its injected into sites across the face, head, the back of the neck and shoulders every 12 weeks.

Although the exact reason why Botox eases migraines is unclear, its thought that it works by suppressing the nerves ability to send signals to the muscles which prevents muscle contraction. Abnormal muscle contraction is reduced by Botox which relaxes stiff overactive muscles. Stiff muscles cause the headaches.

Why Do Botox Injections Cause Headaches For Some Patients

Posted on October 25, 2017 in BOTOX® Cosmetic, Cosmetic Dermatology, Treatments, Anti-Aging, Wrinkles, Rhytides

For nearly a decade and a half, Botox injections have provided a safe, effective treatment for facial wrinkles and creases such as those in the brow line and around the eyes. For many patients, Botox can dramatically improve the appearance of crows feet, horizontal lines on the forehead, and creases between the eyebrows.

Botox does this by temporarily blocking the nerve impulses that stimulate those muscles, which prevents the muscles from tensing and causing the appearance of wrinkles. It can soften the signs of aging and produce a more youthful appearance, notes Sally Santos, Physician Assistant at Sanova Dermatology in Austin, Texas. Improvement can be noted in as little as 48 hours and may last up to four months.

While there are quite a few myths about Botox, there can be minimal side effects from treatment. For a very small group of patients, this side effect may include headaches. Botox-related headaches are extremely rare and are believed to be caused by over-contraction of certain muscles in the face. For most patients, these headaches are relatively mild and short-lived, with symptoms disappearing within a day or two, shares Santos.

Botox has many other uses including the treatment of migraines and excessive sweating . Talk to your dermatologist and see how botox can make a difference for you.

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Read Also: Pressure Points For Migranes

Am I Experiencing Chronic Migraines

If you suffer from 15 or more migraine headaches within a month, then youre considered to have chronic migraines. Symptoms of a migraine headache often include:

  • Severe pain on one or both sides of the head
  • Throbbing or pulsing discomfort
  • Jerking or other uncontrollable movements
  • Weakness in the face or one side of the body

After the attack during the postdrome stage, patients often report feeling drained or confused for up to a day. You may also experience brief bursts of pain whenever you suddenly move your head.

As you know, dealing with chronic migraines can completely consume your life. Just as youre recovering from one migraine, another one occurs. Its a frustrating, debilitating event that may leave you feeling hopeless.

For chronic migraine sufferers, regaining a better quality of life isnt just about treating the actual migraine. Its all about prevention!

Preventing migraine attacks starts with understanding what causes them. So, lets dive into migraine pathophysiology even further

When Botulinum Toxin Injections For Headaches Make Your Symptoms Worse

Fact Or Myth  Does Botox Treat Migraines!

For some people, botulinum toxin injections will help relieve a good portion of their headache symptoms, headache severity, and headache frequency. For some people, botulinum toxin injections will make their headache symptoms, headache severity, and headache frequency worse. In this article, I will discuss how botulinum toxin injections may affect you.

If you are reading this article you are likely someone who was recently recommended botulinum toxin injections for headaches and you would like to learn a little more, or, you are someone who had botulinum toxin injections and not only did the injections not help you, they made your situation worse and now you are looking for possible answers. You may also be someone who had botulinum toxin injections with great success and you are wondering why they are now wearing off, and your headaches have returned.

The people we see in our office are not the people who had great long-term success with botulinum toxin injections. We see the people for whom the headaches got worse and as the headaches got worse, so did other neurological problems such as vision difficulties, hearing difficulties, dizziness, and more.

Some people contact us after their first series of botulinum toxin injections. They had a treatment a few weeks back, yet they still have terrible muscle spasms, their headaches are just as bad as they have been, and now they have developed new neck pain. They are here in our office to find out why.

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Is Botox Effective For Migraines

Yes. However, its been proven only to work for people who suffer from:

  • migraines 15 days a month or more
  • chronic migraines more than eight days a month

In both cases, the migraines last more than four hours.

People who have been successfully treated report that they experience fewer migraine days each month.

Botox is not an effective treatment for:

  • less frequent migraines
  • tension headaches

Could Botox Cause Any Side Effects That Affect My Brain

No, Botox isnt known to cause side effects that affect or damage the brain.

The toxin effects of Botox can sometimes spread from the area where the injections are given,* causing a condition called botulism. This condition involves widespread problems with the way nerves communicate with muscles. But this doesnt affect the brain.

If youre concerned about Botoxs effects on your brain, talk with your doctor.

Learn more about some of the side effects Botox may cause.

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Botox For Upper And Lower Limb Spasticity

Botox is FDA-approved to treat certain types of muscle spasticity. With this condition, your muscles contract involuntarily and become stiff. Upper and lower limb spasticity can cause stiffness in your elbows, hands, fingers, ankles, or toes. Muscle spasticity can be painful, and it can make it difficult for you to do daily activities.

Specifically, Botox is approved to treat:

  • upper and lower limb spasticity in adults
  • upper and lower limb spasticity in children ages 2 to 17 years

Upper or lower limb spasticity may occur after someone has a stroke. In fact, these conditions can affect between 20% and 30% of people whove had a stroke.

But limb spasticity may also be caused by nerve disorders, such as multiple sclerosis and cerebral palsy . Brain or spinal cord injury can also result in limb spasticity. All these conditions can damage nerves in your brain, causing them to malfunction and result in limb spasticity.

To treat limb spasticity, Botox is injected into certain muscles in the affected arm, hand, or leg. The drug works by stopping nerves from sending signals that are causing the muscles to be spastic. This action of Botox allows the muscles to relax.

The effect of Botox injections for limb spasticity typically lasts about 12 weeks. After that point, the drugs effect wears off and repeat treatment may be needed.

Effectiveness for upper and lower limb spasticity

Effectiveness in adults with upper or lower limb spasticity

In these studies, at 6 weeks after treatment:

Is Botulinum Toxin Injections Long Lasting How Long Do They Last

Botox Injections for Migraines: Day 1, getting the injections

An October 2021 study examined 80 patients with chronic migraine were included. In this study, doctors from two of Turkeys leading hospitals Departments of Neurology gave Onabotulinumtoxin A across 31 fixed-sites and if the patient had pain, and lesser dose injections were applied across 8 specific head/neck muscle areas. Headache days and analgesic intake were noted before the Onabotulinumtoxin A injection and during the interviews at the first, second, and third months after the Onabotulinumtoxin A injection.

  • The average number of headache days per month before Onabotulinumtoxin A treatment was about 19 days.
  • This number decreased to 10.5 days per month in the first month
  • This number decreased to 9.3 days per month in the second month
  • But this number increased to just about 12 days per month in the third month

Pain medication needed:

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Botox Injections And Side Effects

By Liz Segre contributions and review by Charles Slonim, MD

Botox Cosmetic has been available by prescription in the United States since the FDA approved it in 2002. The exact same Botox injected for medical purposes was first approved by the FDA in 1989.

Botox Cosmetic is FDA-approved to smooth the frown lines between your eyebrows, though it is used off-label for other facial wrinkles as well.

In 2017, botulinum toxin was the top nonsurgical cosmetic procedure in the U.S., with 1,548,236 injections performed by physicians and their physician assistants and nurse injectors. That is up 30 percent from the 1,190,995 botulinum toxin injections performed in 2012.*

In this article we present only the facts, as well as recommendations from respected medical professionals. After reading this article, contact your doctor for answers to questions about your botox injection regimen, reactions and concerns.

How To Predict If Botox For Migraine Is Going To Help

In some patients, Botox dramatically reduces the frequency of migraine attacks, while it has no effect for others. Approximately 65% of patients with chronic migraine respond to onabotulinumtoxin A after 3 courses of treatment.

Dr. Rami Burstein conducted a study published in 2006 which searched for a neurological marker that differentiated between migraine patients who respond to Botox treatment and those who do not benefit from it.

Different types of pain

Dr. Burstein found that some patients perceive their pain as pressure buildup inside their head while others perceive their pain to be inflicted from the outside in .

Among those who did not respond to Botox, 92% described a buildup of pressure inside their head .

Among those patients who responded to Botox, 74% perceived their head to be crushed, clamped or stubbed by external forces .

According to Dr. Mauskop in his 2009 New York Headache blog, many more patients suffer from imploding headaches or headaches with pain in the eye than with exploding headaches.

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What Should I Expect When Having The Treatment

During your first consultation, your practitioner will assess your health and check that Botox is a suitable treatment for your migraines.

They will ask you a series of questions, including:

  • how many days a month you suffer from migraines or headaches
  • how many hours they last
  • how severe the pain is
  • whether the pain affects your day-to-day activities
  • where you experience migraines
  • what other migraine symptoms you experience

They will also ask you about your medical history and health in general, including:

  • what medication youre currently takingor have taken in the pastto treat your migraines or headaches
  • how well you feel your current medication is working
  • any other medical condition you have and what medication youre taking for these
  • any allergies you have
  • whether youre pregnant or breastfeeding

Your practitioner may carry out tests to check your overall health, such as:

  • blood pressure
  • pulse rate
  • breathing rate

If your practitioner is happy with your overall health and agrees youre a suitable candidate for Botox, your treatment will begin.

Why Were You Or Why Are You Being Recommended To Botulinum Toxin Injections Then

Botox Migraines

Botulinum toxin injections can help many people. These are typically the people we do not see in our office. We see the people as I mentioned earlier in this article who had botulinum toxin injections and continue to have headaches and worsening symptoms related to Cervical dystonia, also called spasmodic torticollis.

In an April 2020 study, researchers in Italy writing in The Journal of Headache and Pain describe benefits that some may achieve with botulinum toxin injections. They also suggest to their fellow doctors which patients may benefit the most or the least from Botulinum toxin injections. Here are the summary learning points:

Also Check: Ear Piercing Relieves Migraines

How Is Botox Given

Botox injectionsshould be given only by a trained medical professional, even when used for cosmetic purposes.

This medicine is injected into a muscle by a healthcare provider. Botox injections should be spaced at least 3 months apart.

Botox injections may be given into more than one area at a time, depending on the condition being treated.

While receiving injections for eye muscle conditions, you may need to use eye drops, ointment, a special contact lens or other device to protect the surface of your eye. Follow your doctor’s instructions.

If you are being treated for excessive sweating, shave your underarms about 24 hours before your injection. Do not apply antiperspirant or deodorant for 24 hours before or after you receive the injection. Avoid exercise and hot foods or beverages within 30 minutes before the injection.

It may take up to 2 weeks after injection before neck muscle spasm symptoms begin to improve. You may notice the greatest improvement after 6 weeks.

It may take only 1 to 3 days after injection before eye muscle spasm symptoms begin to improve. You may notice the greatest improvement after 2 to 6 weeks.

The effects of a Botox injection are temporary. Your symptoms may return completely within 3 months. After repeat injections, it may take less and less time before your symptoms return, especially if your body develops antibodies to the botulinum toxin.

Mayo Clinic Q And A: Botox A Treatment For Chronic Migraines But Not A Cure

DEAR MAYO CLINIC: Is it safe to use Botox injections to treat chronic headache? How does it work, and would I need to have regular treatments? Do patients who use Botox as treatment need to be on other headache medication, too?

ANSWER: Onabotulinum toxin A, or Botox, is approved by the U.S. Food and Drug Administration as a treatment for chronic migraine headaches. It is not a cure. People who receive Botox for headaches usually get the treatment about every three months. For some, that is all they need to keep their headaches under control. For others, additional medication or other headache treatment is necessary.

Botox is a medication that uses a form of botulinum toxin to paralyze muscle activity temporarily. Best known for its ability to reduce the appearance of facial wrinkles, Botox also has been shown to help prevent chronic migraine headaches in some people. Its used mainly for those who have headaches more than 15 days a month.

Since 2002, doctors at Mayo Clinic have treated thousands of patients with chronic migraine effectively and safely using Botox. The medication typically is injected into muscles of the forehead, scalp, neck and shoulders.

The specific details of how Botox works to prevent headaches are not known. But, its likely that the injected Botox is taken up by pain receptors in the muscles nerves. The medication then deactivates those pain receptors and blocks pain signals that the nerves send to the brain.

Read Also: Migraine With Facial Numbness

Let’s Talk About Migraines Namely Chronic Migraines

First of all, for those who aren’t familiar with migraines, they’re different from headaches. Headaches are unpleasant, too, but are typically less severe than migraines and don’t usually present with other symptoms besides the pressure and aching in the head. Migraines, on the other hand, can be much more intense and often come with nausea, seeing spots, vomiting, extreme fatigue, sensitivity to light and sound, and more.

They affect 39 million folks in the U.S., 4 million of whom deal with daily pain. Chronic migraines can severely inhibit daily life, and when I started to feel like my bad days were outnumbering my good, I knew I needed to find a solution. Botox had been suggested to me multiple times before by friends, family, and doctors, and though it took quite a while to get it approved by insurance and find a provider I trusted, my migraines were making it hard to live a normal life, so I decided to try it out.

Spread Of Toxin Effects

Treating Chronic Headaches with BOTOX Injections

boxed warning for the spread of toxin effects. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Botox can sometimes spread from the area where the injections are given. This can cause a serious condition called botulism.

Botulism can occur hours, days, or even weeks after receiving a Botox injection. Symptoms of botulism can include:

The spread of toxin effects is rare, but it may be more likely to occur in people receiving Botox for limb spasticity, especially children.

The spread of toxin effects hasnt been reported in people using recommended doses of Botox for migraine, excessive sweating, blepharospasm or strabismus. To learn more, see the drugs prescribing information.

What might help

After youve had Botox injections, avoid rubbing or massaging the area where you had the injections for a couple of days. This will help avoid spreading the toxin into other areas.

If you have symptoms of botulism after receiving Botox, call your doctor right away, even if its been several days or weeks since your last injection. You may need treatment in a hospital.

Its especially important to get medical help right away if you have trouble breathing, swallowing, or speaking after having Botox injections. If your symptoms feel life threatening, call 911 or your local emergency number.

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What Causes Chronic Migraines

Pinpointing the exact causes of migraine headaches can be complicated. Why? A confluence of factors may be to blame.

Researchers believe that genetics and family history make individuals more prone to developing migraine headaches. The weather, specifically a change in barometric pressure, may play a slight role. Unfortunately, theres not a lot you can do to intervene in factors such as these.

But dont lose hope. Many other contributing factors to migraine headaches can be addressed.

According to the American Migraine Foundation, medical conditions such as anxiety, mood disorders, insomnia, jaw disorders, asthma, sleep apnea, and hormonal changes may trigger migraines. Luckily, many of these problems are treatable conditions.

Your lifestyle may also trigger migraines. Adverse lifestyle factors that can contribute to migraines often include:

  • Excess stress
  • Consuming certain foods or food additives
  • Medication overuse

To gain better insight into the causes of your specific migraine headaches, you should consider keeping a headache diary. Journal about when your migraine started, the symptoms, how long it lasted, and what contributing factors may be to blame.

A headache diary can be an invaluable resource for your doctor and/or treatment team to pinpoint the recurrent events that trigger your migraines. Furthermore, your doctors can use this information to develop an effective plan of action to eradicate your migraines.


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