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How To Prepare For Botox Injections For Migraines

Is Botox Right For Treating My Migraine Attacks

How To Properly Prepare Botox For Injection – Dr. Cosentino – Empire Medical Training

If youre thinking about Botox treatment for your migraine attacks, here are some questions you might consider and talk with your doctor about:

  • Are your migraine attacks chronic? Chronic migraine is defined as taking place 15 days , on average, out of every month. If your migraine attacks arent chronic, its unclear whether Botox would be helpful for you.
  • Are you okay with multiple treatments? Botox might not be effective to treat migraine after your first treatment, and even when it works, it isnt permanent. Youll need to plan to get regular Botox treatments every 3 months if Botox becomes your long-term treatment plan.
  • Will your insurance cover it? Your insurance may only cover Botox for migraine if you can document that youve already tried other treatments. Even then, you may have a hard time getting approval from some insurance providers. If you dont have insurance, Botox can become costly, especially when you add up the cost of multiple treatments.

What Are Common Side Effects Of Botox

There are very few side effects associated with Botox treatments. The needle used is very small while some people may feel a small pinch with the injection, many dont feel anything.

Other side effects can include some neck pain and muscle weakness where the medication was injected. Using ice packs can help reduce this pain if it happens. Rarely, people can experience eyelid drooping or muscle weakness in areas further away from the injection site.

Studies have shown that up to five treatment cycles of Botox is safe and effective for chronic migraines.

Am I A Good Candidate For Botox For Chronic Migraine

You may be a good candidate for Botox injections if you are an adult suffering from chronic migraine headaches. Botox is not FDA approved for people with migraine who have 14 or fewer headache days per month.

Because Botox can cause serious side effects, it is important to tell your doctor about any other medical conditions you have and any medications you take. You may be at higher risk for serious side effects, such as difficulty swallowing or breathing, if you have neuromuscular conditions such as amyotrophic lateral sclerosis , myasthenia gravis, or Lambert-Eaton syndrome.

You should not receive Botox injections if you have had an allergic reaction to any botulinum, including:

  • Myobloc®

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How Do You Prepare For Botox For Migraines

Before administering Botox for migraines, your dentist will perform a thorough consultation and assessment. Botox may not work on all types of chronic headaches, so it is important to confirm its potential merit for your situation. If you are a good candidate for treatment and have not received Botox injections in the past four months, you may undergo the procedure during the same appointment. That said, you may also need to schedule your treatment for another day to allow time to stop taking medications or supplements that thin the blood. Doing so can decrease your chances of post-treatment bruising. Aside from your consultation and avoiding certain products, there are no other steps to prepare for a comfortable, effective treatment.

Summary Of Possible Side Effects:

Botox For Migraines
  • A temporary worsening of your migraine for some days or a migraine attack on the day of treatment. These should be treated with your usual medication.
  • The skin is cleaned before the injections are done but as with all injections, infection, bleeding, tenderness, and bruising are possible where the injections are placed. This will usually be minor and last no more than a few days.
  • Drooping of the eyelid or brow. It is important not to rub the areas where the injections were done for the first 24 hours. Cleaning the forehead, washing the hair, applying make-up is best avoided until the drug is fully absorbed during that first day.
  • Minor changes to expression lines in the forehead are possible.
  • Weakness and pain in the neck and shoulders which can last a few weeks. If this happens you should let your clinic know and they may avoid injecting those areas in future treatment sessions.
  • If you have found no benefit after the second treatment, a third treatment may be given, or an alternative will be considered.

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What To Expect During The Procedure

Botox appointments are very quick and can be done right in your doctors office in about 15-30 minutes. You dont need to do anything to prepare, but your doctor may ask you to stop taking certain medications a few days prior to the injection. You should also inform your doctor if youve had a Botox injection in the past four months, even if it wasnt an injection for migraines.

During your appointment, your doctor may numb your skin with a topical anesthetic. You may receive several shots during the procedure in the areas on your head and neck where you feel pain. The shots may feel like a slight pinch.

After the procedure, youre welcome to go home immediately. Its safe to drive yourself home, but you may want to bring someone along just in case.

Note:Injections should ONLY be given by a licensed health care provider who has been trained to administer Botox for migraine treatment. There is a high risk for complications when injections are performed by unlicensed or untrained individuals.

Ongoing Evidence To Support Botox

Further prospective and retrospective studies support the results of the PREEMPT study. The COMPEL study, which began in 2011, included 716 patients with an average of 22 headache days per month. The participants received 155 units of Botox at the 31 injection sites from the established migraine protocol every 12 weeks for 2 years. Just over half the participants completed the study and by weeks 60 and 108, there was a significant reduction in headache days reported.

In 2019, researchers reviewed the data from 211 patients who received Botox at 7 private neurology practices in Australia. The study found 74% of patients benefitted from Botox treatments, including reduced headache days and a decrease in the number of days they used acute pain medication.

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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.

Do Not Drink Wine For One Week Before Your Appointment

Botox Injection for Chronic Migraine

BOTOX can give you a more youthful appearance with results that look subtle and natural. While theres no downtime after treatment, one factor may prevent you from benefiting from its effects as soon as possible: facial bruising.

Drinking wineand consuming red wine in particularcan increase your chances of bruising following BOTOX. To avoid this, Walnut Creek patients should plan to give up wine for seven days before they come to see Dr. Manios.

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Your Insurance May Or May Not Cover It

Because it’s an FDA-approved treatment, your health insurance may cover all or most of the cost of Botox, though this depends on your specific plan. The drug manufacturer also offers a savings program that can help offset some of the expense.

To get approval, your insurance company may want to see that you’ve “failed” on two or three oral preventatives first. You may also need to keep a headache diary that shows you’re having 15 or more headache days per month.

Once you’ve started the shots, your insurance will probably require documentation of improvement to continue paying for the treatment. Depending on your plan, you may also need to come for a follow-up visit between shots.

Note, however, that if Botox is used as an off-label treatment , insurance companies may not cover it, per the AMF.

Are The Injections Painful

The needles used for Botox injections are very small and a skilled injector will do them fast enough, but needling is never agreeable.

If you have allodynia related to your chronic migraine, or if you are in the midst of an attack, injections can be more painful. Controlling your breathing is a good way to decrease the pain , especially if you are very nervous. If Botox is effective for you, the likely scenario is that the injections will be easier to tolerate over time.

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Tips To Prevent The Side Effects Of Botox For Migraines

    Having BOTOX® treatments is becoming widely accepted for migraine sufferers, and for many people, it has made a world of difference to the frequency and severity of their migraine attacks. Few patients experience side effects, but for those who do, its possible to prevent some of the side effects if you take the right steps. Each BOTOX® treatment consists of an average of 32 injections, although some patients require fewer than this, while others need more. Depending on your symptoms, the injections are administered into your forehead, temples, the back and sides of your neck, the upper shoulders, or the back of your head.

    Being Ready The Day Of The Treatment

    Botox could help ease your migraine
  • 1Work out before the procedure. Many doctors suggest waiting at least 24 hours to exercise or exert yourself after your treatment. If you work out every day, do it before your appointment. A little physical activity can relax you before the appointment and ensure that you get in your daily workout without any stress.
  • 2Cleanse your skin. Your doctor needs your skin to be free of any dirt, moisturizers, or cosmetics before your treatment. Make sure that you cleanse your skin thoroughly before your appointment and dont apply anything until after the treatment.
  • Wash your face with a mild soap or cleanser and warm water. Make sure to rinse it thoroughly to prevent any residue on your skin. Pat dry with a soft towel so you dont irritate your skin.XTrustworthy SourceMayo ClinicEducational website from one of the world’s leading hospitalsGo to source
  • Recognize that your doctor may clean your skin again with rubbing alcohol or an antiseptic cleanser before the injection to remove anything you werent able to wash off.
  • 3Calm your nerves before the injection. Even if you exercised to help relax yourself, you may still be nervous or have anxiety before your Botox treatment. You can help relieve your nerves and anxiety by trying some of the following techniques:XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source
  • Distracting yourself by talking to your doctor or a nurse
  • Breathing slowly and deeply
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    How Much Does It Cost And Does Insurance Cover It

    It can also be expensive. Depending on your insurance, it can cost quite a lot of money â I’ve changed insurance providers since I first started, and my first provider was around $330 a month and charged me around $1,000 per Botox round . My new plan is much more expensive, around $600 a month, but the Botox copay is only $30 each time, so even if Botox is the only medical procedure I need to have done in the year, it made sense to switch.

    The last thing I’ve found to be a little frustrating is that my body tends to metabolize the Botox a bit faster than I can get it. While Ravitz tells me I can’t get the treatment any more frequently than every three months, because that’s the rate at which the body can develop antibodies against it, I find my migraines amping up in frequency again about two to two and a half months after I get the shots. However, given the fact that with the Botox, my migraines have gone down from about four a week to one or two at most, it’s absolutely increased my quality of life, and I’m glad I gave it a shot…or 40.

    Botox Injections For Chronic Migraine Headache

    If you have not achieved significant improvement in your chronic migraine headaches, or have had intolerable side effects with trials of at least two different daily preventative, prescription medications, your neurologist may consider prescribing Botox injections.

    The Botox injection procedure for chronic migraines involves 31 intramuscular injections with a very small needle . The procedure is done every three months and can take at least two treatments to notice a significant improvement in headaches.

    This is a treatment with Food and Drug Administration indication for chronic migraines in adults, and in studies it has also been found to be safe and effective in adolescents. The treatment is usually well tolerated by patients 12 years and older.

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    Use A Gentle Facial Cleanser

    The right hygienic regimen can keep your skin healthy and beautiful. However, you may be using an aggressive facial cleanser, which can cause an infection after BOTOX injections. Dr. Manios can advise you about alternative cleansers if necessary. You can return to your normal hygienic routine 24 hours after your procedure.

    Learn more about how to get the most from your treatment with BOTOX. Walnut Creek patients can schedule an appointment with Dr. Manios online or by phone at 989-6560.

    How It Relieves Migraines

    How Botox treatment for migraines has changed lives

    Botox is a medical substance created from the bacterium Clostridium botulinum toxin. When purified of its bacterial substances, it creates a neurotoxin complex injected in small doses into the areas of the neck and forehead, weakening the muscle contractions and blocking the nerve signals. Botox specifically blocks the chemical messenger called acetylcholine from attaching to the never endings that meet with the muscle cells. For patients who receive Botox as a migraine treatment, the treatment:

    • Last for 10-12 weeks with one initial dose
    • Reduces migraines by approximately 50% with multiple treatments
    • Treats people 18 or older, and is used as an off-label treatment in adolescents
    • Takes up to 6 months for patients to see maximum results from the treatment

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    Are Botox Injections For Migraines Painful

    Botox injections can be uncomfortable when used for migraines. The dentist may begin your treatment by applying a numbing medication to the injection area. However, this might be difficult on the scalp. If you are concerned about your injections being painful, talk to your provider about ways that your comfort will be managed. Typically, injections feel like a slight pinch that lasts just a moment.

    Customized Botox For Migraines In Seattle And Tacoma

    The board-certified cosmetic surgeons at Seattle Plastic Surgery have over a decades experience in BOTOX injections. Using revolutionary injection techniques that reduce the risk of side effects, our plastic surgeons will ensure a comfortable and safe procedure.

    Seattle Plastic Surgery is located across from Swedish Hospital on Broadway in Seattle. We offer private treatment rooms that provide a sterile and comfortable environment for your BOTOX for migraines injections. With a warm and friendly environment, you will never feel unwelcome in our office.

    Your cosmetic surgeon will customize your treatment to address your concerns and migraines. From the injection sites to the amount of units used, you can feel confident that your plastic surgeon wants to help you see long term migraine prevention.

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    How Botox Is Given

    Botoxs form is a powder that comes in a single-use vial. The drug is mixed into a liquid solution. For preventing headaches in adults with chronic migraine, the medication is given as intramuscular injections. Youll receive these from a healthcare provider.

    Injection sites

    Because intramuscular injections are given directly into a muscle, you may be wondering where they are injected for migraine headaches. Here are the Botox injection sites:

    • between your shoulder and neck on your right and left sides
    • at the back of your neck, by the base of your skull on both your right and left sides
    • the back of your head, behind each ear
    • the middle of your forehead, above each eye
    • the lower part of your forehead, right above your nose
    • the lower part of your forehead, near the inside edge of each eyebrow
    • behind each temple, above the ear

    What If Botox For Migraine Stops Working

    Botox Treatment in Mumbai

    In a very small number of patients, Botox loses its effectiveness over time.

    This happens either because the person develops antibodies as a defense mechanism to block the effect of Botox or migraine evolves and stops responding to Botox.

    According to Dr. Alexander Mauskop, fewer than 1% of patients develop antibodies to Botox. However, patients who develop antibodies to Botox , may respond to a similar product, Myobloc, which is a type B toxin. Myobloc is not approved by the FDA to treat chronic migraine. However it has a similar mechanism and has been shown to relieve migraine in several studies.

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    You Can Technically Get Botox For Migraine And For Cosmetic Reasons At The Same Time

    This is where it gets a little murky, and opinions vary depending on who you ask. The manufacturer of Botox recommends not exceeding 400 units in a three-month span. Since your neurologist will administer 155 units, technically you have wiggle room if you want to visit an esthetician for Botox, too. However, this can be problematic.

    “There is a theoretical risk of developing antibodies to Botox if it’s given more frequently,” explains Dr. Donnelly. If you’d like to do both, it’s best to check with your provider before booking an appointment with your esthetician.

    Overall, if you’re finding yourself planning your life around your migraines, you may want to make it a point to chat with your doctor about using this multitasking drug to reduce the frequency of the attacks. I know doing so has drastically changed my life-and it might help you, too.

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