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How Many Botox Shots For Migraine

Side Effects And Warnings

How Botox treatment for migraines has changed lives

Botox can produce side effects. It should always be injected by a trained professional. If your anatomy is asymmetric, or if the dose you receive is not exactly equal on your left and right sides, you may develop a slightly lopsided facial appearance for a few months until the medication starts to wear off.

Other side effects that can occur include:

  • Muscle weakness
  • Neck stiffness
  • Neck pain or soreness

Technically, Botox is a toxin, not an infection. But some people develop an immunity to the toxin, making it ineffective. You can develop this reaction whether you are getting Botox for muscle disease, cosmetic reasons, or migraine prevention.


There are also some rare, but potentially serious and life-threatening adverse events that can occur after a Botox injection. These effects may occur as a result of very high injection doses, unusual sensitivity to the medication, or to spreading of the medication to other areas beyond the injected muscle.

These adverse events may occur hours to weeks after injection and require immediate medical attention.

Get emergency medical attention if you experience any of the following:

  • Problems swallowing, speaking, or breathing
  • Loss of muscle strength
  • Double vision, blurry vision, inability to open one or both eyelids
  • A hoarse voice, slurred speech
  • Loss of bladder control

What Are The Potential Side Effects

I asked this question as Ravitz was putting the first needles in my face, which was probably a mistake as I get anxious easily. However, she assured me that the side effects of Botox typically don’t happen at the doses prescribed for migraines, and even if the scary-sounding side effects you read about online do occur , they aren’t particularly dangerous and last four to six weeks.

“Most commonly, people have pain because youâre dealing with a bunch of shots, and sometimes you can get a headache from the procedure,” Ravitz tells Allure. “You may have heard about eye droops, but you usually donât see that. It can happen, but we try to keep it very symmetric so that it doesnât happen at all.”

Personally, I typically experience a headache after the procedure, but I attribute that mostly to tension and anxiety that comes from anticipating pain. It usually goes away before the next morning, and that’s the only notable side effect I’ve experienced in the five rounds of Botox I’ve had so far.

Is There A Needle Size And Saline Dilution That You Find Most Useful

The ideal needle to use is a 30G or 31G, half-inch needle. Longer needles are problematic as they encourage deeper injections, which can increase the risk of muscle weakness, and most of the side effects such as neck pain stem from muscle weakness. Perseverative-free normal saline is the only diluent that should be used. There is a case study of a patient who died when onabotulinumtoxinA was mixed with a local anesthetic agent. The pivotal trial established an effective dose using 2 mL/100 units of onabotulinumtoxinA. A fact that is often overlooked is that the mean dose in the trial was 165 units. The patients all received 155 units with a fixed dose, fixed-site injection protocol, and an option of an additional 40 units to follow the pain. This resulted in a mean dose of 165 units, which is the standard that should be used to achieve the efficacy results reviewed above.

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Finding A Doctor Who Treats Migraine With Botox

If you want to try Botox for migraine, you should look for a headache specialist or neurologist. We recommend using your insurances doctor listing, Yelp, or the American Migraine Foundations doctor database.

Dr. Laura Banks, neurologist at Natividad Medical Center, suggests asking prospective doctors where they learned to give Botox, and how many times theyve given it. Youre looking for a lot of experience, she says. Dr. Andrew Blumenfeld suggests asking doctors how many injections they will give, and where they will give them.

How Soon Does The Treatment Start Working

My Experience With Botox for Migraines

It usually takes two treatments for patients to notice a major difference in the number of migraines they experience.

You receive the first two treatments 12 weeks apart. You may only notice a slight improvement after the first treatment. By the second treatment you should notice a gradual reduction in the number of migraines you experience and an improvement in your overall quality of life.

At this point, your practitioner will assess whether you would benefit from treatment every 12 weeks as a preventative measure.

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How Botox Helps Migraines

The understanding of how Botox may help migraines is still developing. The idea behind Botox for migraine prevention has long been that paralyzing the muscles of the head prevents muscle contraction that may contribute to headaches.

However, this theory has been questioned because Botox is more established as migraine prophylaxis and has not been found effective in preventing tension headaches.

Some evidence suggests that botulinum toxin may also have an impact on neurotransmitter release in the brain and on the brains pain receptors.

Research on Prevention

Studies suggest that Botox has a small to moderate positive effect when it comes to preventing migraines. There have been many small trials examining the effect of Botox injections on migraine frequency and severity.

For example, a study in Spain included 69 participants who had chronic migraines. Each received an average of two botulinum toxin injections. The study authors reported that participants experienced a significant reduction in their pain intensity and number of headache days over the 16-month duration of the study.

A larger review included data from 28 trials, including a total of 4190 participants. The researchers only included randomized double-blind controlled trials, a standard that is considered the most reliable and unbiased method of testing a medication. Participants received various brands of botulinum toxin injections.

What To Expect After Botox Injections For Migraines

For most patients, it takes two sessions of treatment before there is any significant improvement. Because you have the first two procedures 12 weeks apart, its important not to expect an immediate difference in the number of headaches you experience.

Theres no recovery time required after having the treatment and you dont have to do anything specific to ensure the treatment works. Its simply a matter of waiting for the treatment to work. You can return to your normal activities straight away.

The effects of the treatment usually last around 1012 weeks, with results starting to wear off after 10 weeks.

Results show that Botox reduces the number of headaches in 70% of people who are treated with it, making it an effective treatment for many patients. However, its important to note that the treatment doesnt work for all patients.

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The Risk Of Side Effects Is Low

“Botox injections can occasionally trigger a headache, muscle weakness and neck pain, but this is rare,”Kerry Knievel, DO, director of the Jan & Tom Lewis Migraine Treatment Program at Barrow Neurological Institute in Phoenix, Arizona, tells Health. “Eyelid and eyebrow asymmetry and droop can happen, but to prevent this we recommend that patients refrain from rubbing their foreheads or wearing a hat for 24 hours after their injections to prevent the Botox from spreading from the area we intend for it to be.”

In fact, Botox’s limited side effects are part of its appeal. “It’s not addicting. You don’t have to take a pill every day. It doesn’t work for everyone, but it does work for a significant amount of people. That’s why Botox is amazing,” says Dr. Bashir.

How Do I Access Botox

Botox Injections for Treatment of Chronic Migraine

Botox is only available on the NHS for people with chronic migraine who have tried at least three other preventive treatments. It is currently only available via a specialist such as a headache specialist or consultant neurologist.

If you think you are eligible for Botox and would like to considered for treatment you can ask for a referral to a specialist. The specialist will assess your history and symptoms to make sure Botox is an appropriate treatment option for you. You should be asked to keep a headache diary to monitor the effectiveness of the treatment.

If Botox doesnt work for you or stops working your specialist will discuss other treatment options with you.

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What Is Treatment Like

When you receive your first Botox treatment, expect the appointment to take about 20 minutes. The doctor uses a very small needle that feels like a pinprick. He or she injects small amounts of Botox into shallow muscles in the skin. Each treatment typically involves 31 injections in seven key areas of the head and neck.

The most common side effect from the Botox shots is a sore neck, and we recommend using an ice pack to reduce the discomfort.

It can take up to six months to see the maximum benefit from Botox. In the meantime, you can continue your regular medications with no risk of a drug interaction.

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How Much Does Botox For Migraines Cost

The cost of Botox treatments can vary somewhat, so its important to ask your healthcare provider upfront what you will be charged.

In general, each treatment session will use a total of about 155 units of Botox, and that can cost anywhere between $300 to $600, or even more. Because these treatments can be expensive, you should search for coupons or savings plans that are available to help lower the cost. For example, the manufacturer of Botox, Allergan, offers a savings card and a patient assistance program to help reduce costs or even make it free for patients.

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When You Should Consider Using Botox For Migraine Treatment

Botox injections are not a first-line treatment and are only considered when other means of managing chronic migraine havent succeeded. Notably, this treatment is not indicated for acute migrainewhen there are less than 15 attacks a month.

Though widely tolerated, some conditions and diseases can contraindicate their use or warrant extra monitoring and caution. These are:

  • Allergy to Botox: Hypersensitivity to the botulinum toxin in Botox can lead to anaphylactic shock, characterized by swelling, breathing difficulties, nausea, vomiting, and skin rashes.
  • Neuromuscular disorders:Those with disorders affecting the junction between nerves and muscles, such as myasthenia gravis and Lambert-Eaton syndrome, are at a higher risk of adverse events, such as respiratory problems.
  • Infection at the injection site:If infection arises due to injections, treatment is discontinued.
  • Being pregnant or nursing:There hasnt been adequate testing on the safety of Botox during pregnancy or when breastfeeding. Its typically not recommended for this population.
  • Age: The safety of this treatment has not been determined for children under the age of 18, so this treatment is typically avoided.
  • Respiratory problems:A history of respiratory issues might also warrant cautious use as Botox can affect lung function.

Botox Injections For Spasticity

Botox Injections For Fewer Wrinkles

Spasticity is a muscle control disorder that involves tight or rigid muscles and the inability to control them. Spasticity is caused by signaling problems between the central nervous system and the muscles in the body.

Patients with cerebral palsy, traumatic brain injury, stroke, spinal cord injury, or other conditions affecting the spinal cord often experience spasticity.

The benefits of Botox for spasticity include better movement and range of motion, decreased pain and improved gait pattern.

Generally, this treatment option takes no longer than 20 minutes to perform. Most patients start to see results within a few days, with maximum results occurring a couple of weeks later. Relief from spasticity symptoms lasts approximately three months.

Botox used to treat spasticity is covered by most medical insurance providers including Medicare and Medicaid.

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How Often To Get Botox For Migraine Prevention

If you undergo Botox treatments for migraine, your doctor will typically administer them once every 3 months. Getting Botox injections more frequently isnt well studied so the risks are currently unknown.

After treatment, some people may improve significantly and are able to discontinue treatment without relapse. Depending on your response to Botox, your doctor will recommend a length of time for your treatment plan.

How Is Botox For Migraines Different From Cosmetic Botox

The Botox used for migraines and the Botox used for cosmetic procedures is actually exactly the same. “Basically, young and middle-aged women were getting for cosmetic purposes, and thatâs the most common person that has migraines, and thatâs how they figured out it was helpful,” Ravitz tells me. Women were getting Botox for aesthetic reasons and happened to notice relief from their migraine symptoms, and doctors began looking into it as a direct treatment. In fact, women are disproportionately affected by migraines â about 85 percent of chronic-migraine sufferers are women, and the condition affects 28 million in just the U.S.

The only difference between the two procedures is that with Botox for migraines, they may do a few more shots in areas where the pain is experienced. Personally, I usually get between 30 and 40 shots, concentrated mostly on the right side of my head where the pain occurs, at the base of my skull, and on my neck and shoulders, where I tend to hold tension, as doing so can cause a migraine. Botox for migraines can have the same aesthetic effect that cosmetic Botox has, which kills two birds with one stone for people who may desire that effect. “We do it along wrinkle lines and keep it symmetrical,” says Ravitz, which explains the erasing of lines and temporary plumping of wrinkles.

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In A Survey 92% Of Current Botox Users Said They Wish Theyd Talked To Their Doctor And Started Botox Sooner*

I had the first injection and I had really kind of overthought everything and made it seem much worse than it was going to be. Jennifer

Remember, only a doctor can determine if BOTOX® is right for you, too. Not sure where to start? Download the Doctor Discussion Guide.

*2020 BOTOX® Chronic Migraine Patient Market Research BOTOX® Current Users .

AbbySo, the first time I was going to get my BOTOX® I was super nervous. I did not know what to expect.

AliciaI was afraid for a couple reasonsone, I was afraid it was going to hurt.

JenniferI had the first injection and I had really kind of overthought everything and made it seem much worse than it was going to be.

KatieThey were fine. It just was little injections.

AbbyThe shots were tiny.

So, they start in the back of your neck. And then theyll do the sides, and then they do the top and the front. And it only took about 15 minutes.

CourtneyOnce were done, I go on with my day.

AliciaThe benefit outweighs the pain for sure. I find if I breathe through it, its certainly easy enough. Its not nearly as bad as a migraine.

Please see Important Safety Information including Boxed Warning at the end of this video or on the website below.

A Quick Guide To Botox For Chronic Migraines

BOTOX for Migraines, Animation. | A Quick Guide to Botox for Chronic Migraines | Only a migraine sufferer knows how debilitating a migraine can be. What causes migraines remains difficult to diagnose, making finding the right treatment a long and disheartening struggle.

For many people, medication alone doesnt do enough to control their migraines. If you experience more than 15 migraines each month, botox for chronic migraines could be the right treatment for you.

The idea of botox injections might seem a little frightening to you. Thats why weve done the research to find out exactly how safe it is to treat migraines with botox. Heres what we learned.

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Billing Tip: Botox Injections For Chronic Migraine Sufferers 1359o

Botox injections for chronic migraine sufferers may now be submitted to the Alberta Health Care Insurance Plan using HSC 13.59O.

  • Botox treatment may be used for chronic migraine sufferers for persons aged 18 to 65 who suffer from migraines more than 15 times a month and have been recommended for this treatment by their physician.
  • Follow-up treatment may be claimed in 12 week intervals.
  • Only one call may be claimed regardless of the number of injections performed.
  • May be claimed in addition to a visit or consultation, when appropriate
  • Services for patients under the age of 18 or more than 65 years of age must be billed directly to the patient as this is considered an uninsured service by Alberta Health

Patients may be charged for the Botox following the College of Physicians & Surgeons of Alberta Standards of Practice Dispensing of Schedule 1 or 2 drugs by a physician for a fee.

The Botox injections for migraines may be claimed in addition to a visit or consultation as appropriate. However, the time spent performing the injections may not be included in the time claimed for complex modifiers or prolonged visits/consultations.

Benefits Of Botox For Chronic Migraines

Botox is an effective FDA-approved treatment for chronic migraines. It can help reduce the number of migraine days you experience and reduce the intensity of your migraine symptoms.

Studies show that many people who use botox for migraines experience more clear, pain-free days each month and miss fewer days of work.

Heres how botox works. It gets injected around the pain fibers in your face, neck, and scalp that contribute to migraines. The botox enters those nerve endings and stops the chemicals that transmit pain signals to the brain.

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Botox Treatment For Migraines: What You Need To Know

Around one in seven people across the world experience a migraine at some point in their life, according to The Migraine Trust. Approximately two percent of the global population deals with chronic migraines. If youre a part of that two percent and you deal with migraine headaches often, youre likely wondering what you can do to reduce their occurrence and prevent them.

In 2010, Botox was approved for the treatment of chronic migraines in adults. While youve likely heard of it being used as a cosmetic treatment for forehead lines and other facial lines and wrinkles, its also been proven effective for some individuals suffering from migraines. Heres a look at what you need to know if youre considering this treatment.

What is Botox and How Does It Work?

Botox is a type of neurotoxin, which is a poison thats made by Clostridium botulinum bacteria. If you ate it in spoiled food, it could cause a severe and deadly reaction known as botulism because it blocks the signals from nerves paralyzing muscles. However, its safe for injections because the toxin isnt digested, and you get a much smaller amount than what youd encounter in spoiled food.

Injections of Botox smooth wrinkles with its ability to relax the facial muscles. Botox is also found to help people with spasms and tics due to nerve diseases.

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